First English Lutheran Church
Sunday School & Youth Registration Consent Form
2019-2020
Only One Registration per form
Please complete a registration form for all youth age 2 through College
Post High youth (college) please include school address
Name of Youth: *
Your answer
Age: *
Your answer
Date of Birth: *
MM
/
DD
/
YYYY
Date of Baptism
MM
/
DD
/
YYYY
Grade in School *
E-mail address *
Your answer
Parent(s) or Caregiver(s) Name *
Your answer
Address: *
Your answer
City: *
Your answer
Zip Code: *
Your answer
Primary Phone Number *
Your answer
Secondary Phone Number
Your answer
Post High College Address
Your answer
Emergency Contact Person (other than parent): *
Your answer
Emergency Contact Phone: *
Your answer
Emergency Contact relationship to youth: *
Your answer
Allergies/ Conditions *
Your answer
Prayer Partner - *
Permission
By agreeing to this form, my son/daughter has my permission to participate in First English Lutheran Church Sunday School and Youth Events (including off site travel) from September 2019- August 2020. I understand that photographs may be taken of my child that may be posted within the church or on the Youth/FELC web locations and that no personal information about my child will be disclosed.
Electronic Signature: *
Your answer
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