2025-26 Transportation Form
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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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Child 1 First Name
*
Last Name
*
gender
*
Please select one option.
Male
Female
School Grade
*
Please select one option.
K
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Select Option
K
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Child 2 First Name
Last Name
gender
Please select one option.
Male
Female
School Grade
Please select one option.
K
1
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Select Option
K
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Child 3 First Name
Last Name
gender
Please select one option.
Male
Female
School Grade
Please select one option.
K
1
2
3
4
5
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11
12
Select Option
K
1
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Child 4 First Name
Last Name
gender
Please select one option.
Male
Female
School Grade
Please select one option.
K
1
2
3
4
5
6
7
8
9
10
11
12
Select Option
K
1
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Child 5 First Name
Last Name
gender
Please select one option.
Male
Female
School Grade
Please select one option.
K
1
2
3
4
5
6
7
8
9
10
11
12
Select Option
K
1
2
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I, the undersigned, give my consent for the person(s) identified above to be transported by Lifeway Wesleyan Church (LWC) and will assume all liability for their participation in this activity/event and any illness or injury that may result during the transport or at the event/activity. Further, by signing below: 1. I will not hold Lifeway Wesleyan Church, its officers, agents, employees, assigns or anyone acting on its behalf, responsible or liable for illness or injury occurring to the named person(s) in the course of such activities or such travel. 2. I hereby accept financial responsibility for any personal items lost by the person(s) identified herein. 3. I also understand that disrespectful behavior and language and/or disregard for rules of safety by the person(s) listed above while riding the LWC van/bus will require that I find alternative transportation for said person(s) to and from the LWC program/event. 4. I accept full responsibility and hereby grant permission for the above named person(s) to travel with Lifeway Wesleyan Church. This Waiver and Release will be valid for all transportation occurring as of and after the date below. This Waiver and Release is valid through July 2026.
*
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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