Children and Youth Ministries Registration 2019-2020
Please fill out one form below for each child or youth participant. You are welcomed and encouraged to participate.

Please “Like” the Facebook page, Peace Lutheran Church for additional updates.

Are you interested in helping out? We welcome you to help with one-time commitments or long-term volunteering! There are many opportunities to serve in this ministry. Please fill in the volunteer form using this link if you have registered all of your children and you can be a helper: https://forms.gle/Z2AkTZ6d7kcDFJENA Thanks!
Program I am signing up for:
Parent/Guardian #1 Name: *
Your answer
Parent/Guardian #1 Phone: *
Your answer
Parent/Guardian #1 Email: *
Your answer
Parent/Guardian #2 Name: *
Your answer
Parent/Guardian #2 Phone: *
Your answer
Parent/Guardian #2 Email: *
Your answer
Please list 2 Emergency Contacts and Phone #'s:
Your answer
Student's Full Name: *
Your answer
Birth Date: *
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Age as of Sept. 1, 2019 *
Your answer
Grade: *
Required
Baptism Date:
MM
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DD
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YYYY
Are there any medical conditions or allergies that we should be aware of and ready to respond to?
Your answer
Do you give permission for your child's photo to be released for publicity purposes? (for example, on church social media or website. Children's names will never be posted along with their photos.) *
Required
I am the parent/legal guardian of the participant named on this form, and hereby grant my permission for him/her to participate fully in Peace Lutheran Church's related events and activities. In the event of an emergency and I cannot be reached, I give permission for the supervising Peace Lutheran staff or adult leader to sign forms that would ensure the necessary and immediate treatment of the participant. Parent/Guardian signature: *
Your answer
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