2025-26 Lifeway Students Registration
Please fill out this form and click submit.
Parent/Guardian Name
*
Email
*
This address will receive a confirmation email
Phone
*
Address
*
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Child 1
Child 1 First Name
*
Last Name
*
gender
*
Please select one option.
Male
Female
Birthdate mm/dd/yy
*
Allergy Information
*
Please select one option.
Yes, please explain below
No
Select Option
Yes, please explain below
No
Medical Concerns
*
Please select one option.
Yes, please explain below
No
Select Option
Yes, please explain below
No
School Attending
*
School Grade
*
Please select one option.
7
8
9
10
11
12
Select Option
7
8
9
10
11
12
Child 2
Child 2 First Name
Last Name
gender
Please select one option.
Male
Female
Birthdate mm/dd/yy
Allergy Information
Please select one option.
yes, please explain below
no
Select Option
yes, please explain below
no
Medical Concerns
Please select one option.
yes, please explain below
no
Select Option
yes, please explain below
no
School Attending
School Grade
Please select one option.
7
8
9
10
11
12
Select Option
7
8
9
10
11
12
Child 3
Child 3 First Name
Last Name
gender
Please select one option.
Male
Female
Birthdate mm/dd/yy
Allergy Information
Please select one option.
yes, please explain below
no
Select Option
yes, please explain below
no
Medical Concerns
Please select one option.
yes, please explain below
no
Select Option
yes, please explain below
no
School Attending
School Grade
Please select one option.
7
8
9
10
11
12
Select Option
7
8
9
10
11
12
Transportation needed?
*
Please select one option.
yes
no
Select Option
yes
no
For and in consideration of Lifeway Wesleyan Church, enrolling my child(ren) to participate in Studnet Ministies & its related events and activities, hereby voluntarily indemnifies, releases from liability, and holds harmless Lifeway Wesleyan Church for any accident, injury, loss, or damage to person or property, arising or resulting directly or indirectly from my child(ren)’s participation in the program. In the event that my child(ren) is injured, I, the parent/guardian agree to assume any financial obligation, either through personal health insurance, or through some other means, for any medical costs which my child(ren) incurs. I have read this and agree.
*
Please select all that apply.
Yes
I certify I am the parent/guardian and have authority to enroll my child(ren) in this program.
*
Please select all that apply.
Yes
Today's Date
*
Submit
Description
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