Route 56 Registration Form 2017 - 2018
Cost for Route 56 is $50 per child. Please make checks payable to Peace Lutheran and note in memo line child/children names. Financial assistance is available upon request. Please fill out a separate registration form for each child. Thank you!
Child's Name *
Your answer
Birth Date *
MM
/
DD
/
YYYY
Grade in School in 2017 *
Name of Parent(s) *
Your answer
Email Address *
Your answer
Parent Cell Phone *
Your answer
Student Cell Phone (if applicable)
Your answer
Home/Mailing Address *
Your answer
Health Concerns/Special Instructions *
Your answer
I authorize my child to participate in all Route 56 related activities. *
My child's photo can be used on Peace's website and Facebook page. (Please note that photos of kids will be taken during youth activities, but if you answer "no", the pics will not be used for promotional purposes.)
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