CHARACTER EDUCATION FOR THE REAL WORLD

Student Registration for LifeWise Van Wert
In addition to their Van Wert City School classes, parents have the option of enrolling their children in LifeWise Academy.

• LifeWise Academy is a non-denominational, Bible-Based Released Time Religious Instruction Program with emphasis on Character Education.
• Students will walk with chaperones to and from their LifeWise classes
• For more details, visit our website at lifewiseacademy.org/vanwert
Student information
Name*

First NameLast Name
Birth Date *

MonthDayYear
Grade for 22-23 school year*
Classroom Teacher (Optional)
Student Email Address*
example@example.com
Student Phone Number*
Please enter a valid phone number.
College Credit Option*

Student intends to pursue college credit for this classStudent does NOT intend to pursue college credit for this class
Parent information
Name*

First NameLast Name
Email Address*
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Does your student have any health concerns or food allergies we should be aware of? If yes, please list:
*Should a health or allergy related concern arise during the program, LifeWise personnel will contact the school directly after taking appropriate action.
I consent to my student participating in the LifeWise Academy Released Time Bible Education Program. *This permission slip will remain valid as long as your child is enrolled at VWCS.

Yes, I choose to allow my child to attend LifeWise Academy classes
I consent to the photography or video of my student while in LifeWise, for promotional purposes.

YesNo
Signature

Clear
Should be Empty:

Student Registration for LifeWise Van Wert

Student information

Parent information