Off-Campus Waiver Form

IMPORTANT NOTE: Students are not permitted to go off-campus until Monday, September 21, 2026.

“Off Campus” is defined as a grade 8 – 12 Senior School privilege to leave the campus of White Rock Christian Academy (WRCA) during lunch period and study blocks (11/12 only) and NOT during class times, chapel, other assemblies, or times when there is a substitute teacher in class. Be aware that during the student’s exercise of the off-campus privilege, the school administration may not know the destination, whereabouts, and/or activity of the student.

Please note that, in the Parent Agreement portion of the consent form, references to “I” or “my” mean and apply to each parent or guardian signing this form. Each signatory agrees to be bound by the terms of this agreement.

This form will need to be signed by the student and parent(s) where applicable.

Step 1 of 2

Student Information

Please fill out a separate consent form for each of your children.

Student First Name(Required)

Student Last Name(Required)

Cell Phone

Homeroom(Required)

Student Agreement

Please carefully read the following statements and check each box to indicate your agreement and understanding.

Student Signature(Required)

Date: 08/30/2026

Parent / Guardian Information

For the purposes of this agreement, references to “I” or “my” in the Parent Agreement mean and apply to each parent or guardian signing this form. Each signatory agrees to be bound by the terms of this agreement.

First Name(Required)

First Name of Parent / Guardian 1

Last Name(Required)

Last Name of Parent / Guardian 1

Phone(Required)

First Name

First Name of Parent / Guardian 2

Last Name

Last Name of Parent / Guardian 2

Phone

Parent Agreement

I am permitting my child to go off campus during lunch period (G8 – G12) and study blocks (11/12 only). I agree to the following:

Parent / Guardian 1 Signature(Required)

Parent / Guardian 2 Signature

Date: 30/08/2026