LifeKids Registration

Pre- Register your child here! We want to make your first time with us as smooth as possible!

First Name (adult)

Last Name

Email

Phone Number

Address 1

Address 2

Country

City

State

Zip/Postal Code

Child's Name

Last Name

Grade in school

Birthday

Special Need's/ Allergies

Relationship to Adult

Child's Name

Last Name

Grade in School

Birthday

Special Needs / Allergies

Relationship

By checking this box, I hereby give Life Church permission to use any still and/or moving image, being video, photo, and/or frames, and/or, audio footage depicting my/our children taken for the purposes of Life Church training, promotional material, and publications, and waive any rights of compensation or ownership thereto
I Consent

Submit