Faith Formation Registration Form

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2026-2027 Registration form for Faith Formation Students.

Section One: Registration Form

Student's Name(s), Birthday, Grade, and School (if applicable):

Parent/Guardian Name(s):

Home Address:

Parent/Guardian Cell Phone(s): (Please note if you do not wish to receive text messages)

Parent/Guardian Email(s):

Allergies: (If multiple children, be sure to indicate which child)

What is one thing we should know about your child(ren)? Also, is there anything we should be aware of medically, socially, or developmentally for your child(ren)?

Section Two: Parent Permission Form

My child(ren) has/have my permission to participate in Faith Formation classes at FELC. [Write name of child(ren)]

During this activity I can be reached at: [phone number(s)]

I/we further agree that I/we will hold harmless Faith Evangelical Lutheran Church in Walworth, WI, leaders, church staff and volunteers, and those participating in Faith Formation, from all claims which may arise out of participation in Faith Formation, including activities before and after meal and designated class time. I/we further agree to hold harmless Faith Evangelical Lutheran Church in Walworth, WI from any and all claims which may result from any injuries or fatalities arising out of participation in this event.

In the event that my child sustains an illness or injury requiring immediate medical attention, I/we, give my/our permission to those in charge to administer and/or seek emergency medical treatment. I/we understand that this includes any hospital treatment or the administration of any medicine or drug that is so advised by a licensed physician and/or surgeon. I/we expect to be contacted as soon as possible in the event treatment is needed.

I/we understand that a copy of this form is as valid as the original.

[Name(s) of parent(s)/guardian(s) & date]

Medical Conditions [list with child(ren) name(s)]

Current Medications [list with child(ren) name(s)]

If parents/guardians cannot be reached, please provide the following information:

[Please list Emergency Contact, Phone Number and Relationship to Student(s)]

Section Three: Photo and Video Release

Faith Evangelical Lutheran Church in Walworth, WI will sometimes use photos and videos to promote our Faith Formation and Confirmation programs through newsletters, websites, press releases, social media, etc. No names will be used.

Faith Evangelical Lutheran Church in Walworth, WI wants to include photos and/or videos to be used for informational or promotional purposes.

I give permission to FELC to use my child(ren) for photos/videos.

I do not give FELC permission to use my child(ren) for photos/videos.

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Child(ren) name(s):

Name(s) of parent(s)/guardian(s) & date

Thank you for your support and involvement in our program! It is important for children to see their loved adults being active along with them in Faith Formation. Please feel free to share any ideas and comments with Pastor Lily or Sarah in the office.

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