CHARACTER EDUCATION FOR THE REAL WORLD

Student Registration for LifeWise Upper Arlington
In addition to their regular 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.

• Elementary students attend classes during their scheduled Explorations time. Middle school students attend during their lunch time (Jones is Tuesday; Hastings is Thursday). High school students attend during their lunch time on Wednesday.

• Students will ride a van/bus with chaperones to and from their LifeWise classes.

• For more details, visit our website at lifewiseacademy.org/upperarlingtonoh
Student information
Student Name*

First NameLast Name
Student Birth Date *

MonthDayYear
Grade for 23-24 school year*
School*
Classroom Teacher*
*If known
T-Shirt Size
Parent information
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address*
Additional Parent/Guardian Name

First NameLast Name
Additional Email Address for Classroom Communications
example@example.com
NoYes
If the answer was “Yes” to the above please explain your child’s needs and someone will reach out to you to ensure your child has appropriate support for the classroom.*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please list any student health concerns or food allergies we should be aware of (please put “none” if they don’t have any allergies): *
Should a health or allergy-related concern arise during the program, LifeWise personnel will contact the school directly after taking appropriate action.
Yes, I choose to allow my child to attend LifeWise Academy classes.
YesNo
YesNo
*If a shared parenting plan is in place requiring dual consent, both parents are required to submit a separate form with a signature.
Signature
Should be Empty:

Student Registration for LifeWise Upper Arlington

Student information

Parent information