CHARACTER EDUCATION FOR THE REAL WORLD

Student Registration for LifeWise Bath
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.
• Students attend classes during their assist time before or after their lunch period, one day a week.
• Students will travel with chaperones to and from their LifeWise classes.
• For more details, visit our website at lifewiseacademy.org/bathoh
Student information
Name*

First NameLast Name
Birth Date *

MonthDayYear
Grade for 23-24 school year*
Classroom Teacher
*If known
Parent information
Name*

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

Clear
This permission slip will remain in effect as long as the child is enrolled with Bath Local Schools
Should be Empty:

Student Registration for LifeWise Bath