Faith Formation Registration
St. John's Lutheran Church
1403 Newman St., Bloomer, WI 54724
715-568-5446
Registration for ALL Faith Formation groups (JAM, Confirmation, and Youth in Action)
Today's Date *
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Parent(s)/Guardian(s) *
Address *
Cell Phone *
Can Pastor Martin or Katie O'Connell text this phone number to send reminders, upcoming events to be aware of, or other church/ministry related reasons? *
Secondary Phone
Email Address *
Emergency Contact (other than parent/guardian) *
Emergency Phone *
List all authorized people to whom my child(ren) may be released: *
Can we use pictures taken of Sunday/Wednesday activities for promotional events, on our website, or on our Facebook page? *
Which day will your child participate? *
Are you flexible on which day your child participates if we needed to split numbers to accommodate kids to create a safer learning environment? (Specifically for children in JAM) *
Can Pastor Martin or Katie O'Connell text your child(ren) to send reminders, upcoming events to be aware of, or other church/ministry related reasons? *
Child 1's Name *
Child 1's Birth Date *
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Child 1's Grade *
Child 1's Allergies/Medical Information *
Child 1's Cell Phone (if applicable)
Child 2's Name
Child 2's Birth Date
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Child 2's Grade
Clear selection
Child 2's Allergies/Medical Information
Child 2's Cell Phone (if applicable)
Child 3's Name
Child 3's Birth Date
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DD
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YYYY
Child 3's Grade
Clear selection
Child 3's Allergies/Medical Information
Child 3's Cell Phone (if applicable)
Child 4's Name
Child 4's Birth Date
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DD
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YYYY
Child 4's Grade
Clear selection
Child 4's Allergies/Medical Information
Child 4's Cell Phone (if applicable)
Child 5's Name
Child 5's Birth Date
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DD
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YYYY
Child 5's Grade
Clear selection
Child 5's Allergies/Medical Information
Child 5's Cell Phone (if applicable)
Child 6's Name
Child 6's Birth Date
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DD
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YYYY
Child 6's Grade
Clear selection
Child 6's Allergies/Medical Information
Child 6's Cell Phone (if applicable)
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