Living Water Homeschool Registration Form
This form will auto-fill an e-mail for Living Water.
Parent's First and Last Names:
Example: Paul and Holly Poteete
Home Phone Number:
Cell Phone Number:
Mommy's Birthdate (Month and Day only, MM/DD):
Please include your children's names and birthdates:
Example: John Doe 02/02/2002
Positions (First Choice):
Positions (Second Choice):
Positions (Third Choice):
Emergency Contact Name:
Emergency Contact Phone Number:
How did you hear about Living Water?:
1. By registering below I agree with the
Statement of Faith.
2. I have read and will fully comply with all Living Water Co-op policies for this school year.
3. As a volunteer, I will be dependable, reliable, and professional in representing Living Water Co-op.
4. I am drug-free.