Welcome to Walnut Grove Christian School!

Thank you for completing the Crowders Ridge Waiver. We also need you to complete the WGCS PERMISSION FORM below:

Complete information below to sumbit permission form for WGCS:

14th Annual High School Retreat

When: August 24th-25th Where: Crowder’s Ridge 130 Camp Rotary Road Gastonia, NC 28052 Arrive at school by 8:15am, August 24 Students will return from Retreat by end of school day August 25

Student Information

Student's Name(Required)

First Last

Student's Grade(Required)

Parent's Name(Required)

First Last

I give permission for my student listed above to travel to Crowders Ridge with Walnut Grove Christian School.(Required)

I give permission for my student to attend

14th Annual High School Retreat Crowder’s Ridge 130 Camp Rotary Road Gastonia, NC 28052 This year we will be staying in the bunk houses.

My child has a health concern or a physical limitation/injury that may prevent participation in some aspects of this retreat. (If yes please explain below)(Required)

Yes

Explain Health Concerns if answered YES above:

Medications? Please list what they are and frequency of distribution OR if none, please enter NONE below(Required)

On the morning of Wednesday, August 24th, please present all medication to Mr. Boyd

Please check the box below to confirm attendance policy for this event.(Required)

I understand that my student is considered ABSENT from school if they choose not to attend without an approved absence.

Please check the box below to confirm Cell Phone Policy.(Required)

I understand the Cell phone policy - If one is brought, it will be collected before we leave the school and returned upon their arrival back to school. Mr. Boyd can be reached by the school at any time. If someone is found with their technology after arriving at Crowders Ridge, a parent will be called and will have to come pick up their child. After a mandatory parent/student conference the following Monday morning at 7:30am, further disciplinary action will be taken.

Please check the box below to confirm rules on what not to bring.(Required)

I understand my student can not bring anything illegal or prohibited at WGCS & NO ELECTRONICS..

Parent Signature(Required)

Entering your name and submitting this form is the same as if you had signed in ink according to the ESIGN Act of 2000. Your computer's IP address and today's date will also be captured with this form submmission.

Student Signature(Required)