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Church School Enrollment Form
Please fill out the form for each of your children. Thank you for joining The Well Academy. We look forward to serving your family in the coming years!
Public School District*
School Year*
YYYY
Name of Student*

First NameMiddle NameLast Name
Student's D.O.B.*

MonthDayYear
Date
Grade*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*

Area CodePhone Number
Parent's Email
John.Smith@domain.com
Name of Parent/Guardian*

First NameLast Name
I hereby certify the child identified above is enrolled with The Well Academy and I give prior consent* to the administrator of The Well Academy to notify the public school superintendent should the above named student cease attendance at this school.

*Alabama Code 16-28-7 states should the child cease attendance at a church school, the parent, guardian, or other person in charge or control of the child shall by prior consent at the time of enrollment direct the church school to notify the local public school superintendent or his or her agent that the child no longer is in attendance.
Signature

Clear
Date*

MonthDayYear

Church School Enrollment Form