CHARACTER EDUCATION FOR THE REAL WORLD

Student Registration For LifeWise New Albany

2023-2024
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.
• New Albany Primary School students (Grades 1-3) will meet during their Technology special time. That schedule is determined by the school.
• New Albany Intermediate School students (Grades 4-6) will meet one time per week during lunch and recess. Day of the week will be determined based on registrations.
• Students assume responsibility for any missed schoolwork.
• Students will be transported to and from their LifeWise classes by program staff or volunteers.
• For more details, visit our website at lifewise.org/newalbanyoh.
Student information
Student Name*

First NameLast Name
Birth Date *

MonthDayYear
Gender
Grade for 2023-2024 school year*
Classroom Teacher
*If known
Parent/Guardian information
Parent 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 child have any health or allergy concerns? If yes, please check this box and click https://form.jotform.com/240206767851156 to complete a Medical Action Plan.
Should a health or allergy-related concern arise during the program, LifeWise personnel will contact the school directly after taking appropriate action.
Does your child have any health or allergy concerns? If yes, please check this box and click here to complete a Medical Action Plan.

Should a health or allergy-related concern arise during the program, LifeWise personnel will contact the school directly after taking appropriate action.
Is there anything we should know about your child, such as special social or learning circumstances?
Yes, I choose to allow my child to attend LifeWise Academy classes during 2023-2024.
YesNo
YesNo
YesNo
This program is not sponsored by the New Albany Plain-Local School District. Student participation is voluntary upon written permission of the parent.
If a shared parenting plan is in place requiring dual consent, both parents are required to submit a separate form with signature.
Signature

Clear
Should be Empty:

Student Registration For LifeWise New Albany

Student information

Parent/Guardian information