BC Stride Running Club
Barren Beyond the Bell
Permission Form
I ____________________, give my child __________________,
Permission to participate in BC Stride Running Club. I
understand that by signing this form, I am acknowledging that
my child has no health problems that would prevent them from
participating in club activities. By signing this form,
I release Barren County High School, the Barren County Board
of Education, the Youth Services staff, and all volunteers, of any
liability related to the participation of my child in this program.
In the event of an illness or accident, I authorize BC Stride staff
or volunteers to render treatment as deemed necessary.
_______________________________
Student Name
_______________________________
Signature of Parent/Guardian
________________
Date
Please contact Aundi Thomas at (270) 646-0505 or Ponniece
Champlin at (270) 312-7080