TBS Application [PRIVATE]

1Student Information

2Family Information

3Additional Information

4Parent / Guardian Recommendation

5Transportation Release

6Medical Release

7Signatures and Payment

*This application should be completed with the applicant and the applicants parent(s) - parent will need to sign off release forms, provide recommendations and provide the teens' medical insurance information.
I certify that I am a current member of Living Stream Church.*
Non-Living Stream Member applications will not be valid and will be refunded, your application will need to be re-submitted November 1st. There will be a loss in the processing fee.
- Yes, I certify
Hidden
Account Type
Hidden
Page applied through
Hidden
TBS Year Applying To
Hidden
Acceptance Status
Hidden
Tuition Status Update:
Student Name*
Prefix First Last
Date of Birth*
MM slash DD slash YYYY
How old will you be upon the start of TBS?*
Hidden
Please upload proof of age*
ex: birth certificate, permit, license, school report card, any government issued ID that shows your birthdate
Drop files here or

Accepted file types: jpg, jpeg, gif, heif, heic, png, pdf, Max. file size: 15 MB, Max. files: 1.
Gender*
- Male
- Female
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Student's Mobile Phone*
Student's Email*
Enter Email Confirm Email
Student's Instagram Handle
Have you attended this program before?*
- No
- Yes
Primary Language*
Other Language*
Residency*
Other Residency*
Upload Portrait Photo*
Must be a portrait style photo of just you (max 10mb)(only jpg, png)
Drop files here or

Accepted file types: jpg, jpeg, gif, heif, heic, png, Max. file size: 15 MB, Max. files: 2.
T-Shirt Size*
Do you have any physical disabilities, serious illnesses, or allergies?*
- No
- Yes
If yes, please explain*
Thank you for your interest! Unfortunately, due to high demand, we have reached capacity and the applications for all girls and 14-15 year old boys is now closed.

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Father/Guardian's Information
Name*
First Last
Address*
Same as student

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Father's Mobile Phone*
Father's Email*
Enter Email Confirm Email
Mother/Guardian's Information
Name*
First Last
Address*
Same as student

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Mother's Mobile Phone*
Mother's Email*
Enter Email Confirm Email

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I certify that the following portion is being filled out by a parent/guarding of the applicant.*
- Yes, I certify
Parent/Guardian's Recommendation*
Please describe your teen's good qualities & capabilities*
Please indicate any areas that your teen should improve in*
Parent/Guardian's Name*
First Last
Parent/Guardian's Signature*

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By signing this form, I hereby release Teens Bible School, as well as its directors, officers, administrators, employees, or other agents from all liability or damages for any and all injury arising from the negligence of any of the above while traveling to this activity via private transportation and/or charter bus.

Name of Location Visiting: SMBS
Date: June 20, 2021 - July 17, 2021
Address: 2016 Anniston Road Jacksonville, FL 32246

Teens Bible School must have this signed form in their possession prior to the date of the specified activity.
Student Signature*
Parent/Guardian's Signature*
I. IF AND WHEN THE BEHAVIOR OF MY CHILD(REN) BECOMES TOO DISTRACTING FOR THE OTHERS ON OR THE DRIVER OF THE CHARTER BUS AND/OR VAN, I ACKNOWLEDGE THAT SHE OR HE WILL BE ASKED TO FIND OTHER TRANSPORTATION TO THE CHURCH AND/OR LOCATION OF ACTIVITY.

II. WE, THE UNDERSIGNED, HAVE READ THIS RELEASE AND UNDERSTAND ALL ITS TERMS AND EXECUTE IT VOLUNTARILY AND WITH FULL KNOWLEDGE OF ITS SIGNIFICANCE. WE UNDERSTAND THAT THERE IS NO MEDICAL INSURANCE PROVIDED BY THE TEENS BIBLE SCHOOL OR THE SLAVIC MISSIONARY BIBLE SCHOOL.
Student Signature*
Parent/Guardian's Signature*

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Teens Bible School Medical Release Form
Student's Name*
First Last
In the event of a medical emergency, I give permission to School Personnel to authorize whatever treatment is necessary and I will accept liability for payment of any bills related to the treatment.

Effective Dates: June 20, 2021 - July 17, 2021
- I DO NOT have medical insurance
Insurance Company*
Policy Number*
Please list any medical problems or special needs (include medication).
Medications can only be issued by School Personnel. A Parent Permission for Medication Administration Form must be filled out by the parent (available by contacting the TBS Office at (888) 308-7627).
Parent/Guardian's Signature*
Parent/Guardian's Name*
First Last
In case of emergency:
Contact Person*
Relation*
Home Phone
Work Phone
Cell Phone*
Other Emergency Number*

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TBS Tuition Payment*
- Deposit ($400)
- Pay in full ($900)
TBS Application Fee*
Price:
TBS Housing Fee*
Price:
Processing Fee (3%)*
Price: $0.00
LSC Member Discount*
Price:
If you just pay the deposit at this time, the remaining balance of $500 must be paid by June 11th, 2021
Credit Card*
Card Details
Cardholder Name
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Scholarship Code
Total
$0.00
I understand that if I have applied to TBS and can no longer attend or my circumstances have changed, the refund of the deposit ($400.00) will NOT be returned in accordance to our REFUND POLICY. In the event that my application is DENIED for various reasons, I will receive a refund of the deposit ($400.00). Application Fee and Processing Fee is non-refundable.*
- Yes, I understand
I have reviewed and agree to obey all rules and schedules of Teens Bible School.*
- Yes, I have reviewed and agree
I certify that all of the information and statements on this application are complete and accurate.*
You will be contacted regarding your application, using this information
- Yes, I certify
Student Signature*
Are you a human?
Please check all the information above to be sure it is correct.

Note: Be patient while your credit card is validated.

Submitting your Registration may take several seconds. Please wait for the process to complete.
Click 'Submit' only once and do not click the 'Back' or 'Refresh' buttons on your browser.
Please wait for your confirmation page to display.
Again, thank you for your patience.

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Father/Guardian's Information

Mother/Guardian's Information

Background Information

Other:

Teens Bible School Medical Release Form

In case of emergency: