Loading Registration Form...
All questions marked by an asterisk are required
Event Name:
New Student Form 2022-23
*First Name:
*Last Name:
Student cell phone:
*Birthday:
*Current worship location:
Leawood (13720 Roe Ave, Leawood)
Downtown (1601 Grand Blvd, Kansas City)
Overland Park (8412 W 95th St, Overland Park)
Blue Springs (601 NE Jefferson St, Blue Springs)
West (2400 W. Valley Park, Olathe)
Brookside (5144 Oak St, Kansas City)
*Grade:
6th
7th
8th
9th
10th
11th
12th
School Attending:
Gender:
Male
Female
Other
[Click here to clear selection for question above]
Preferred Pronouns:
*I wish to receive texts from rezlife:
Yes
No
Parent/Guardian Name :
Parent/Guardian Cell:
Address:
City:
State/Province/Region:
Zip/Postal Code:
*Parent Email Address:
*Retype Parent Email Address:
Changing your email address will
not
change your login ID to the new address.
Save Information:
{Checking this option will save your information for future registrations}