Facebook
Home
Our Program
Get Involved
Student Registration
Contact Us
Search
Menu
Student Registration
First Name
*
Last Name
*
Birthdate
mm/dd/yyyy
Parent Name Prefix
*
Select a value
None
Mr.
Ms.
Mrs.
Dr.
Prof.
Pastor
Parent First Name
*
Parent Last Name
*
Second Parent Name Prefix
Select a value
None
Mr.
Ms.
Mrs.
Dr.
Prof.
Pastor
Second Parent First Name
Second Parent Last Name
Email
*
Email Type
*
Select a value
Personal
Work
Alternate
Home Phone
xxx-xxx-xxxx
Mobile Phone
*
xxx-xxx-xxxx
Work Phone
xxx-xxx-xxxx
Other Phone
xxx-xxx-xxxx
Preferred Phone
*
Select a value
Home
Mobile
Work
Other
Address
*
City
*
State
*
Select a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
*
Country
*
Select a Country
United States
Comment
How often do you attend church?
*
Select a value
Regularly
Occasionally
Holidays
Do not attend church
Church Name
School District
*
Select a value
Armstrong
School Name
*
Select a value
West Hills Primary
Grade
*
Select a value
Grade 2
Grade 3
Grade 4
Teacher
*
Year Attending
Select a value
2022/23
Choose the year you wish to register for.
Does your child have any allergies or medical conditions that we should be aware of?
Emergency Contact First Name
*
Emergency Contact Last Name
*
Emergency Contact Phone
*
xxx-xxx-xxxx
Please check here if your child cannot be included in pictures and videos used to promote Bible2School
Please check here if above information may not be shared with Bible2School partners
I give permission for my child to participate in the Bible2School Program in his/her school. I hereby request my child (named on the form above) to be excused from his/her public school class each week for instruction in the Bible Elective by Bible2School.
I understand my child will be walked or transported to the place of instruction by the Bible2School team.
Bible2School's volunteer staff will serve in loco parentis for me to attest to my child's attendance at the Bible Electives.
I understand that my child may be removed at any point from Bible2School upon written notice from the parent/guardian and likewise Bible2School has the right to remove any student from the program for disciplinary issues.
Bible2School will in no way be responsible for medical treatment or liability resulting from physical conditions existing prior to my child attending our Bible Elective.
I give permission to Bible2School to act on my behalf in my child's best interest in the event of an accident or emergency. I give my permission to the hospital and/or doctor to treat or operate on my child in the event that I cannot be reached.
I agree to the statements outlined above
*
Scroll to top