Christos Permission and New Student Registration For 2017-2018
Student's Full Name *
Your answer
Grade entering in Fall 2017 *
Birth Date *
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Permission (All Christos students)
I give permission for my child to participate in and travel with FoC Lutheran church (including adult teachers, parents and staff members for all church sponsored events from September 1, 2017 through August 31, 2018. I understand that there are inherent risks involved with any trip or activity and I agree to not hold FoC Lutheran Church, its staff or leaders, responsible for any injury or loss incurred while participating in this activity.

In the event of an emergency, I give permission for necessary medical treatment to be provided for my child. I also agree that, in the event that a medical or behavioral issue deems it necessary for my child to be sent home, I will be responsible for any travel costs incurred.

Travel/emergency medical treatment permission verification *
Required
If your child's photo is used on our website or in print, his/her name will not be used in conjunction with it. If you still do not want you child's photo published please check the box below:
New Student Contact Information
Father's Full Name
Your answer
Father's phone
Your answer
Mother's Full Name
Your answer
Mother's phone
Your answer
Street Address
Your answer
City, State, Zip Code
Your answer
Email (you will receive all important information via this email) *
Your answer
Emergency Contact Information (All Christos students)
If I am unable to be reached in an emergency, please contact:
Emergency Contact Full Name *
Your answer
Emergency contact phone number *
Your answer
Medical Information (All Christos students)
Doctor/Clinic *
Your answer
Doctor/Clinic phone number *
Your answer
Insurance company name *
Your answer
Policy number *
Your answer
Group number *
Your answer
Insurance company phone number *
Your answer
Any medical conditions/allergies or learning/behavioral issues we need to be aware of:
Your answer
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