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CCS Consent Form
Columbus City School Consent Form
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(Required)
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(Required)
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(Required)
If your child has medical conditions that RESET, Inc. teachers and volunteers should be aware of, please list and explain them below.
(Required)
If there are none, please type “None”
Consent
By checking each of the following boxes, you are confirming that you have read and agree to each.
Please read & check:
(Required)
I (parent/guardian provided above), the parent/guardian of (student’s name provide above), give permission for the student listed above to attend the Released Time Bible Education class of Reset, Inc. [One consent form per student is required.]
Please read & check:
(Required)
As the parent/guardian, I recognize that certain risks and dangers may occur during RESET, Inc. instruction period or while transporting students to and from the program. These risks include, but are not limited to, hazards of accidents, vehicle collisions, personal injury, and acts of a third person. In consideration of the benefits to be attained by my child in receiving Christian Education instruction, I assume all risks, and do hereby waive, release and forever discharge from any liability the building property owners, transportation companies or persons, Columbus City School District personnel and RESET, Inc., and its board members, staff, teachers, and volunteers. VAT Transportation will provide bus transportation for all students participating in RESET, Inc., in accordance with VAT’s ongoing 2019/2020 agreement with RESET, Inc.
Please read & check:
(Required)
In the event of an emergency, if I cannot be reached, I hereby authorize RESET, Inc. permission to act on my behalf in a medical emergency.
Please read & check:
(Required)
I also understand that this class is not designed to conflict with or replace required credit classes. Students are responsible for school assignments missed during Released Time classes. I also understand that this is a permanent consent form; it will allow my child to attend Released Time until they are withdrawn from the program or change schools.
Please read & check:
(Required)
I, the parent/guardian, understand there may be occasions where video or photos may be taken during classroom instruction or special events such as field trips. I hereby give and assign Reset Inc., School Ministries, and their legal representatives, the right and permission to use and publish, without charge, photographs, videos or other media of this student and their image, or likeness taken. These photographs and/or videos may be used in publications, including electronic publications or in audio-visual presentations, promotional literature, advertising, or in other similar ways.
Please read & check:
(Required)
I further understand that as the parent/guardian, I can remove the child at any point from the program upon written notice, and equally the program has the right to remove any student from the program for any reason RESET, Inc. deems necessary, including but not limited to the following: disciplinary issues, violation of RESET Inc. rules, violence or threats of violence towards any person, student, faculty, volunteer, representative of RESET, Inc. or for being disruptive at any time while in the care of RESET, Inc.
Please read & check:
(Required)
I hereby signify that I am over eighteen (18) years of age and the parent or legal guardian of the student identified above and am competent to contract in my own name.
