2021-2022 Faith Formation Registration Form

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Please fill out each section! If you have any questions about the 2021-2022 Faith Formation year please contact the Faith Formation Director, Anne Weber annecyf18@gmail.com or call the church office.

**Faith Formation for Pre K through 5th grade will be at 10:15am on Sunday Mornings and Confirmation will be Wednesday Evenings.

Child's Name (First and Last) *

Child's Birthday *

YYYY

Grade Child is Entering Fall 2021 *

0-2 year old

3-4 years old

Kindergarten

First Grade

Second Grade

Third Grade

Fourth Grade

Fifth Grade

Sixth Grade

Seventh Grade

Eighth Grade

9th-12th grade

School Attending

Parent/ Guardian Name(s) *

Address *

Email (List the one you use) *

Phone Number *

Members of Lutheran Church of the Good Shepherd

Yes

Clear selection

Emergency Contact during the Faith Formation time (Name and Phone number) *

Known Allergies or Medical Concerns

In case of emergency, I hereby authorize my child to be treated by Certified Emergency Personnel, (ie. EMT, First Responder, Emergency Room Physician) **Please type your name below* *

Photo/Video Release:I hereby give permission for images of my child to be captured during regular and special activities of Lutheran Church of the Good Shepherd through video, photo, and audio media. I am aware and give my permission for these images to be used by Lutheran Church of the Good Shepherd. **Please type your name below** *

Any Questions or Concerns

Submit

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