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Child’s Name                            Date

    When my child is brought to Nacogdoches Christian Academy or picked up from Nacogdoches Christian Academy, I will be certain that a staff member is aware of my child’s arrival and/or departure. I understand that my child will be released only to his/her parents or to person(s) designated by me as listed on the Registration Form or as I have informed the Director in writing. I understand that if there is a last-minute change in plans due to an emergency so that a person who has not been named by me in writing is asked to pick up my child, I will contact the Director by phone, giving the name of this person and other identifying information about this person BEFORE they arrive at the school. This person will be asked to show a current driver’s license for identification. I also understand that if the Director still feels uneasy about releasing my child to this person, my child will remain with the Director until the parents or guardians come for the child.
My child will not be released to anyone other than the individuals listed below:
Please understand that you must notify the office/teacher on a daily basis if anyone besides yourself will be picking up your child. (Even if they are listed below.)

name            phone number                    relationship to child


    I give permission for my child to attend activities away from Nacogdoches Christian Academy involving walking or motor vehicle transportation. I understand that adult supervision will be provided at all times, and that the standards outlined by the Department of Protective and Regulatory Services relating to transportation on field trips will be followed. I hereby release Nacogdoches Christian Academy, its staff and board members, and First Church of the Nazarene from liability in case of injury to my child at any time they are in attendance at Nacogdoches Christian Academy or in attendance at any school activity. The Texas Department of Public Safety requires all children younger than 8 years of age unless taller than 4 feet 9 inches to be secured in the appropriate child safety seat system.  It is the Parent’s responsibility to provide an appropriate child safety seat for all school field trips.  If an appropriate seat is not provided the student will not be allowed to ride in the designated field trip driver’s vehicle.  

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parent signature                                             date