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First Lutheran Church Youth Registration Form 2025-26
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* Indicates required question
CHILD´S INFORMATION
Child's First Name (Preferred)
*
Your answer
Child's Last Name
*
Your answer
Age
*
Your answer
Birthdate (MM / DD / YYYY)
*
Your answer
Grade and School Attending
*
Your answer
Primary Phone
*
Your answer
Address
*
Your answer
City / Zip Code
*
Your answer
Allergies and Medical Conditions
Your answer
Is there anything else we should know about your child?
Your answer
PARENT/GUARDIAN INFORMATION
Parent/Guardian Names
*
Your answer
Cell Phone Number
*
Your answer
Parent/Guardian Email
*
Your answer
EMERGENCY CONTACT INFORMATION (OTHER THAN PARENT/GUARDIAN)
Name
*
Your answer
Relationship
*
Your answer
Cell Phone Number
*
Your answer
MIDDLE & HIGH SCHOOLERS ONLY (next 2 questions)
Youth´s Cell Number
Your answer
Extracurricular Activities (i.e. Band, Sports, Drama, Clubs)
Your answer
PERMISSION
Permission
*
I give permission for my child to participate in all First Lutheran Church activities as planned, noted on the calendar and included in promotional materials.
I authorize First Lutheran Church to take such action is deemed necessary for the care, welfare and health of my child including giving consent for medical treatment. I will not hold First Lutheran Church, staff or volunteers responsible for accidents, claims and damages arising therefrom.
I also give First Lutheran Church permission to use any photography/video of my child taken in conjunction with a First Lutheran Church program in future promotions.
Required
ELECTRONIC SIGNATURE
By clicking the "I accept" box below, you are signing this youth registration electronically. You agree your electronic signature is the legal equivalent of your manual signature on this registration.
*
I accept
I do not accept and will bring a signed, printed copy of the First Lutheran Church Youth Registration to the church as soon as possible.
Required
YOUR NAME
*
Your answer
Thank you for taking the time to complete this youth registration form! We look forward to an exciting year of ministry with your child!
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