Power Hour Registration Form

Power Hour Registration Form

_____________________________________ (Child’s Name) has my permission to attend the After School Power Hour Club at Norwood Elementary School every Thursday beginning March 23 and ending April 13 after school until 4:00 pm

My child will be picked up by whom: ___________________________________________________ Pick up will be behind the school at the regular car line pick up/drop off area. Your child must be

picked up immediately after club ends. Our policies do not allow our teachers/helpers to remain at school after club. If your child is not picked up immediately after club three times, he/she will not be allowed to continue attending.

PHOTOS: You (circle one) MAY or MAY NOT take pictures of my child for Power Hour promos.

_________________________________ parent signature

___________________________________  print name

Child’s name: ___________________________________ B-day_______________ Grade:____

Homeroom Teacher: ____________________________________________________________


(street) (city/state) (zip)


E-mail:_________________________________________ work/cell phone: __________________

Home phone:__________________________________________


Name: _________________________________________ phone: _________________________

Name: _________________________________________ phone: _________________________

Child’s Allergies (peanuts, chocolate, etc)____________________________________________

Church: ________________________________________ Pastor:_________________________

The following persons are allowed to pick up my child if I cannot:
Name: ________________________________________ phone:_________________________

Name: ________________________________________ phone:_________________________

Parent/Guardian Signature: ________________________________________________________

Your Child Will Learn:

  • Respect for authority
  • Positive character qualities
  • Sound moral values
  • Biblical principles

Learn new and exciting songs, verses and character lessons!

Power Hour meets once a week and includes:

  • Dynamic Bible Lessons
  • Inspiring Missions Stories
  • Meaningful Songs
  • Life-changing Scripture MemoryPower Hour is open to all students K-5th grade regardless of their religious background. Parents are welcome to attend with child.Room: Gym
    Power Hour is taught by specially trained Christians who are concerned for the spiritual well-

    being of your child. All of our workers are screened as required by Memorial Baptist Church’s child protection policy.

    The United States Constitution requires schools to respect the right of all external organizations to distribute flyers to students at school if the school permits any such organization to distribute flyers. Accordingly, the school cannot discriminate among groups wishing to distribute flyers at school and does not endorse the content of any flyer distributed at school.  This is not an activity of the school or the School District.

Contact: Tracy Phillips Phone: 910-212-0154

Every Thursday from After School – 4 pm Dates: Thurs., March. 23 – Thurs., April 13

Memorial Baptist Church
873 Pee Dee Avenue, Norwood, NC 28128 Director: Tracy Phillips
E-Mail: tpcef@yahoo.com

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