Equip Leadership Liability/Shuttle Registration 2023-2024

Equip Leadership is only open to those who have completed the application process and been accepted as an Equip Leader/Volunteer. If you have questions about this please contact Amy Edlund at amyedlund@mylifematters.club

Equip Leadership meets every Wednesday from 3-5pm. 

Feel free to register up to 3 of your students on this one form. I tried to keep it simple! 

Permission is for August 1st 2023- August 1st 2024

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Email *
My student has applied and been accepted as an Equip Leader through MLM's application process and interview.  *
1st Student's First Name *
1st Student's Last Name *
1st Student's Gender *
1st Student's Date of Birth *
MM
/
DD
/
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1st Student's School *
Site where student is serving: *
1st Student's Grade (the Fall of 2023) *
2nd Student's First Name 
2nd Student's Last Name
2nd Student's Gender
Clear selection
2nd Student's Date of Birth
MM
/
DD
/
YYYY
2nd Student's School
Site where student is serving:
2nd Student's Grade (the Fall of 2023)
Clear selection
3rd Student's First Name 
3rd Student's Last Name
3rd Student's Gender
Clear selection
3rd Student's Date of Birth
MM
/
DD
/
YYYY
3rd Student's School
Site where student is serving:
3rd Student's Grade (the Fall of 2023)
Clear selection
Student's Street & Mailing Address (list both if different) *
City, State, Zip *
Student's Church: *
Parent/ Guardian 1 Name *
Parent/ Guardian 1 Phone *
Other emergency contacts (optional)
We will offer a shuttles this year on Wednesday afternoon to the Warehouse as needed. 
Does your child need a shuttle from their school? 
If so, we will add them to our list and plan to pick them up. If you end up not needing a shuttle please let us know. 
*
Required
Shuttle Permission *
Required
Allergies/ Medications / Health Notes (if none, write NA) *
Please list any other special attention or needs your child may have that the staff should be aware of.  (if none, write NA) *
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