Registration, Stepping Stones to Shalom

Trust in the Lord with all your heart, and do not lean on your own understanding.
In all your ways acknowledge him, and he will make straight your paths.
(Proverbs 3:5-6 ESV)

Registration Form

Student Name:

Date of Birth:

Age:

Grade:

Parent(s)/Guardian(s) Name:

Cell Phone:

Emergency Contact Name:

Relationship of Emergency Contact:

Emergency Contact Number:

Any relevant information you would like to share about your child:

Date of Registration:

Stepping Stones to Shalom is not held in a handicap accessible facility.
Our staff is not qualified, and will not provide any medical care.

Registration

Registration Form

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