Sunday School Registration Form
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Sunday School Year: September 10, 2023 – May 2024
Child 1 First & Last Name *
(first and last name)
Child 1 Current Age *
Child 1 Date of Birth *
Child 1 Grade in School *
(2023-2024 School Year)
Child 2 First & Last Name
(first and last name)
Child 2 Current Age
Child 2 Date of Birth
Child 2 Grade in School
(2023-2024 School Year)
Child 3 First & Last Name
(first and last name)
Child 3 Current Age
Child 3 Date of Birth
Child 3 Grade in School
(2023-2024 School Year)
Parent/Guardian Full Name *
Address *
City *
State *
Zip Code *
Main Phone *
Secondary Phone
Household Email Address *
Emergency Contact Name *
Emergency Contact Phone Number *
Emergency Contact relationship to minor *
Parent/Guardian's location during Sunday School *
Do you give permission for your child to be dismissed from class on his/her own? *
If not, who may pick up your child from Sunday school?
Allergies or other restrictions that your child’s teacher and/or Sunday school volunteers should be aware of (food reactions, physical limitations): **please specify the child if more than one child in your family is registering for Sunday School.
I, the undersigned parent or guardian, do hereby authorize emergency medical, dental, health or hospital services be rendered to my child upon consent of a Peace Lutheran Church staff member or designated volunteer. The purpose of this authorization is to permit my child to receive emergency medical attention when needed while involved in the activities connected with Peace Lutheran Church’s Education Ministry programs when I or my emergency contact is unavailable to give such consent. This authorization shall be effective from September 1st, 2022 until August 31st, 2023. *
Parent/Guardian First and Last Name
Parent/Guardian Date of Birth *
(used as a digital signature, along with name)
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