Faith Creek Church School REGISTRATION
Sundays September 8, 2019 - May 17, 2020 9:00 a.m.
For children 3 years old - 4th grade
St. John's Lutheran Church, 2451 Fairview Lane, Mound, MN 55364
Parent/Guardian Names *
Your answer
Street Address *
Your answer
City, State, and Zip *
Your answer
Parent/Guardian Primary Cell Number *
Your answer
Parent/Guardian Other Cell Number *
Your answer
Email *
Your answer
Number of Children you are registering *
Your answer
Child 1, First and Last Name *
Your answer
Child 1, Birthdate
MM
/
DD
/
YYYY
Child 1, Grade fall 2019
Your answer
Child 1, Special Concerns (Allergies, Medical, Learning)
Your answer
Child 2, First and last name
Your answer
Child 2, Birthdate
MM
/
DD
/
YYYY
Child 2, Grade Fall 2019
Your answer
Child 2, Special Concerns (Allergies, Medical, Learning)
Your answer
Child 3, First and last name
Your answer
Child 3, Birthdate
MM
/
DD
/
YYYY
Child 3, Grade fall 2019
Your answer
Child 3, Special Concerns (Allergies, Medical, Learning)
Your answer
I give permission for photos and videos taken of my child to be used in future St. John's publications (e-news, Reed or Social Media)
I agree that St. John’s Church, staff and Children & Family volunteers, are not responsible for accidental injuries that may occur during my child's time in class and at other church activities. I authorize medical treatment and additional procedures as necessary.
A donation of $20/child or $30/family is suggested to help cover the cost of curriculum materials and classroom supplies. Thank you!
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service