Student Registration Form
Thank you so much for pre-registering
Student Name
*
First Name
Last Name
Parent/Guardian Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Grade
*
Please Select
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
Contact Number
*
Parent Email
example@example.com
T-Shirt Size
*
Additional Comments or Allergies
By signing below I give permission for photographs, of the child listed above, to be used by Abundant Life Church. The use will include, but is not limited to: website, slideshows, announcements, newsletters, brochures and flyers, for the express purpose of enhancing the ministries associated with Abundant Life Church of Clarkston. I also give permission for Abundant Life Church and its volunteers to seek medical attention, if necessary, for my child.
Parent Signature
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