Promiseland Registration 2018-2019
Immanuel Lutheran Church Promiseland 2018-2019 - FOR CHILDREN 3 YEARS OLD THROUGH 5TH GRADE
Email address *
My child will attend *
Child's Name *
Your answer
Parent(s) or Guardian(s) Name(s) *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Grade in School (or age) *
Address *
Your answer
Phone Number *
Your answer
Allergies or other conditions (food, physical limitations, ADD/ADHD, etc.) *
Your answer
Emergency Contact (name & phone #) *
Your answer
Parent Guardian: I am able to help as... (Please choose at least one) *
Required
Comments:
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms