Trinity Lutheran Girl Pioneers Registration
Please contact Jenny Koch at jenny@sjkoch.com or 715-486-8393 with any questions.
Email address *
Child (First Name) *
Your answer
Child (Last Name) *
Your answer
Grade *
Child Birth Date *
MM
/
DD
/
YYYY
Sibling
Address
Your answer
Email
Your answer
Phone Number
Your answer
Cell Phone Number
Your answer
Guardian Name
Your answer
Childs Interests or Hobbies
Your answer
By checking this box I authorize Lutheran Girl Pioneers to use my child(ren)'s photographs & first name in printed materials and on the Tall Pines District Facebook group page (a closed group). *
Required
Parents *
Required
Here are some of my interests that I could help teach
Your answer
Parent Signature *
Your answer
Fees: $25 per child (to be brought to the meeting and turned into Jenny Koch or placed in the gray lock box in the office with name and note: LGP)
Total Paid
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Sjkoch.com. Report Abuse - Terms of Service