Ignite 2026

Kids!! Join us this summer at Lifepointe Fellowship on Monday nights: June 1st, June 8th, June 22nd, & June 29th 7-8:30pm

Ages Kindergarten complete-5th grade. It will be a fun time of learning about God, singing your hearts out with friends, snacks, & fun outdoor games!
Child's Full Name

First NameLast Name
Grade Just Completed
Any Known Allergies
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Additional Children
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address
example@example.com
Emergency Contact Name (if different from parent/guardian)

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Insurance Company
Insurance Policy Number
Insurance Phone Number
Lifepointe Fellowship-Liability Release Form

As a participant or parent/guardian of below minor child and participant in the programs of Lifepointe Fellowship, I do hearby release, forever discharge and hold harmless Lifepointe Fellowship, and the directors / pastors / volunteers thereof, from any and all liability, claims, or demands for personal injury, sickness or death, as well as property damage and expenses. This release covers transportation and/or drivers provided by Lifepointe Fellowship and its representatives who are properly licensed to drive in the United States. This release also covers meetings on Lifepointe Fellowship property or any other site during programs and activities; also consent to emergency medical or dental treatment, including examination, diagnosis, treatment, anesthetic, and surgical treatment, the undersigned agrees to pay all costs and expenses.
Signature
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Kids!! Join us this summer at Lifepointe Fellowship on Monday nights: June 1st, June 8th, June 22nd, & June 29th 7-8:30pm