Sunday School Child Registration 2023

Parent Information

Parent Name

This address will receive a confirmation email

Phone

Address

Child #1

Name

Birthday

Any Allergies?

Any Medical Needs?

Child #2 (Optional)

Name

Birthday

Any Allergies?

Any Medical Needs?

Child #3 (Optional)

Name

Birthday

Any Allergies?

Any Medical Needs?

Child #4 (Optional)

Name

Birthday

Any Allergies?

Any Medical Needs?

Child #5 (Optional)

Name

Birthday

Any Allergies?

Any Medical Needs?

Statements of Release

I agree to release Shepherd of the Pines Lutheran Church and its volunteers of all liability in the incident of any accidents or injuries which I or any member of my family may incur during any on or off premises Church activity. I give my permission for emergency medical treatment if I cannot be immediately contacted. I give permission to have photos and videos of my child on the church’s website, social media, and publications. Note: Shepherd of the Pines will never publish a child’s name with any of its publications.

Electronic Signature*

*By entering my name in the box above, I am providing my digital signature on this Form.

Sunday School Child Registration 2023

Description

Please Fix the Following