LifeWise Academy Permission Slip

Student Registration for LifeWise Perrysburg
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 the day on a schedule that fits the public school classroom rotation
- Students will travel with chaperones to and from their LifeWise classes
- For more details, visit our website at lifewise.org/perrysburgoh .
Note: This permission slip will remain in effect as long as the child is enrolled with the local public school.
Student information
Name*

First NameLast Name
Birth Date *

MonthDayYear
Grade for 23-24 school year*
Elementary School Name*
Classroom Teacher
*If known
Please list any student health concerns, food allergies or behavioral issues we should be aware of.
Is there any other important information LifeWise needs to know for your child to participate in LifeWise?
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
I consent to the photography or video of my student while in LifeWise, for promotional purposes.*

YesNo
Are there any no contact orders that we should be aware of?
Signature

Clear
LifeWise Academy Perrysburg Permission Slip
Should be Empty:

Student Registration for LifeWise Perrysburg