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Interest Form

* indicates a required answer.

Registration acceptance into LifeShine is based on first-come registration forms, informal interviews, and visits to the program. Inquiring families are encouraged to schedule a visit during our 9 month session to determine if the program is the right fit for your family. If you consider LifeShine during the summer or at the beginning or end of the school year, you are encouraged to contact us to make different arrangements in exploring our program.

Open enrollment for new families begins in March, and continues until all program spaces are filled. Because teachers are working on their lesson plans and we need to determine our budgetary needs, most registration is cut off by July 15th. Please contact us to determine space availability and answer questions after that date. Each registered student is committing to a full day for elementary or individual class(es) if Upper School, offered through the program for an entire semester session.

LifeShine holds a mandatory parent orientation meeting in late August to review policies and update any needed paper work. All registered families will be notified of the exact date and time by August 1st. All parents must attend the yearly registration/orientation before their children can participate at Lifeshine. This also includes current enrolled families.

To begin the registration process, complete and submit the online registration below. Please make sure all forms submitted are filled out completely and accurately. Someone will contact you soon after your registration has been submitted. Please do not make any payments until we have a confirmed space for your family.

If you have any questions about the program or registration, please  contact us.

1. *

Student First Name

2. *

Student Last Name

3. *

Student Birthday (mm/dd/yy)

4.*

Please select grade for the upcoming school year:

5.

Gender

Male Female
6. *

Mother First and Last Name

7. *

Father First and Last Name

8.

Street Address

9.

City

10.

State

11.

Zip Code

12. *

Best Phone Number:

13. *

Parent Email

Strengths and Needs Questionnaire

Please include a brief statement about your child’s strengths and/or needs in each of the areas below. This will be helpful to our teachers in providing the best enrichment environment possible for each child.

14. *

Allergies

15. *

Behavioral

16. *

Social

17. *

Parent: Please include a brief statement about your salvation experience and tell us where your child is spiritually.

18. *

Please tell us how you heard about Lifeshine.

19. *

Are you involved in any other academic program? If so, please list

20. *

Please include a brief statement about the church your family attends.

21.

If accepted into the program, please indicate whether you authorize LifeShine to post photos of your children on their private Facebook page or in the private website area or on displays at events.

Yes No
22.*

Behavior Guidelines

The following behavior guidelines will help facilitate a successful experience for home schooling parents and children attending program classes and activities.

1. Students are to be supervised at all times. Parents should stay with children until supervision is transferred to the appropriate teacher.

2. Students are to be picked up promptly when classes complete. The church office and LifeShine cannot be responsible for any student left unattended.

3. There should be no foolish or irresponsible behavior in the church building or on the church property.

4. Please talk to your child about being respectful and cooperative in class.

5. Students' siblings must be directly supervised by a parent while on campus.

I have read and agree to abide by the behavior guidelines. I understand these guidelines are for the safety and protection of all students and staff of LifeShine. I understand failure to comply with these guidelines will result in expulsion without refund. I understand I am fully responsible for property damage to church facilities, LifeShine property, and/or personal damage caused by misbehavior of my child(ren).

By checking this box, I indicate my agreement to the above policies:

 (1 required)
I agree