Promiseland Registration 2020/2021
Immanuel Lutheran Church Promiseland 2019-2020 - FOR CHILDREN 3 YEARS OLD THROUGH 5TH GRADE
Email address *
My child will attend (When Face-to-Face is offered) *
Child's First Name *
Child's Last Name *
Parent(s) or Guardian(s) Name(s) *
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Grade in School *
Address *
Phone Number *
Allergies or other conditions (food, physical limitations, ADD/ADHD, etc.) *
Emergency Contact (name & phone #) *
Parent Guardian: I am able to help as... (Please choose at least one) *
Required
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