Memorial Lutheran Sunday School Registration Form
To keep our roster and information current on our children here at Memorial, we ask that you please fill out this form and submit it. We are getting ready for Fall activities and ready to share Jesus!
Child's Name (First & Last)
Your answer
Child's Birthday
MM
/
DD
/
YYYY
Grade (As of Sept. 1st)
Special Needs: (Allergies, learning of behavioral challenges, etc, please explain)
Your answer
Parents/Guardians Name(s):
Your answer
Mailing Address:
Your answer
Phone Number(s)
Your answer
Email Address
Your answer
Adults Who May Pick Up Your Child(ren):
Your answer
Emergency Contact (Other than parent/guardian and local)Name & Cell #
Your answer
Medical Release: I, the undersigned parent or guardian, do hereby authorize emergency medical, dental, health or hospital service be rendered to my child(ren) upon consent of a Memorial Lutheran, Sioux Falls, SD member or designated volunteer. The purpose of this authorization is to permit my child(ren) to receive emergency medical attention when needed while involved in the activities connected with Memorial Lutheran, Sioux Falls, SD children's programs when I or my emergency contact is unavailable to give such consent. This authorization shall be effective from August 2017-August 2018.(Sign and date)
Photo Release : May Memorial use this child's first name and/or picture in church publications, including church website/social media?
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