Crown of Life

5K-8 School Registration 2022-2023

Students Full Name(*)

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Name Child Goes By

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Students Address(*)

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Contact Email Address(*)

Please let us know your email address.

Phone Number(*)

CellHome

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Home Phone(*)

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Cell Phone(*)

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Sex of Child(*)

FemaleMale

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Birthdate(*)

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Is enrollee listed above been baptized?(*)

Yes

Would Like More Information

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Family Religion

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Home Church

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Please List any other person(s) living with the Child and their relationship ( If any) to child.

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Please list all Brothers and Sisters living with the Child

Name/Age/Living in the Home

Grade Entering in 2022-23(*)

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Father's/Guardian's Full Name(*)

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Father's/Guardian's Address(*)

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Father's/Guardian's Email (*)

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Father's/Guardian's Contact Number(*)

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Father's/Guardian's Employer and Phone Number(*)

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Mothers's/Guardian's Full Name(*)

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Mothers's /Guardian's Address(*)

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Mothers's/Guardian's Email (*)

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Mother's/Guardian Phone(*)

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Mother's/Guardian's Employer and Phone Number(*)

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Photo and Video Release

Crown of Life School would like to utilized photos for classroom applications, Facebook, Instagram or any other social media. You may also use it in promotional Materials for the Church and School when necessary.

Permission Photo/Video Release

Yes, I hereby give permission for my child to be photographed or videotaped while attending Crown of Life School and functions.

No, I would not like my child to be photographed or videotaped.

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Parent/Guardian Signature

Sign Above

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Date of Signature(*)

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We will need you to fill out an enrollment form, per student that will be enrolling in the 2022-2023 School Year.

1292 Tally Ho Trail
Hubertus, WI 53033

262-628-2550

info@crownoflifehubertus.com

5K-8 School Registration 2022-2023

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