Youth Registration

PERMISSION STATEMENTS:

The form on this page will be considered your permission for your student to participate in all educational activities and fellowship events that are offered on and off site by First Lutheran Church for the 2021-2022 school year with groups from First Lutheran Church. (Please note most outside events require their own release forms.)

I give permission to adult leaders with First Lutheran Church to seek medical treatment for my child in the event of an emergency injury or illness. I also grant permission to the physician selected by First Lutheran Church leaders to secure and administer any treatment deemed necessary, including ambulance transfer and hospitalization. I understand every attempt will be made to contact me or those listed on this form as emergency contacts if such an event occurs.

I give permission for my child’s photos to be taken by First Lutheran Leaders and Volunteers and used on a variety of promotional materials (newsletters, Facebook Group page, church bulletin boards, and/or website).

    Child #1 Information
    • Type in the date
  • Additional Children
  • Click "Next" to skip this page if registering only one child
  • CHILD #2

  • Leave blank if same
    • Type in the date
  • CHILD #3

  • Leave blank if same
    • mm/dd/yy
  • CHILD #4

  • Leave blank if same
  • CHILD #5

    Some description about this section
  • Leave blank if same
  • Address
    • May use "Cell Phone" instead
  • Insurance - Medical
  • List any special medical conditions, allergies, or other medical information for each child.
  •  
  • Electronic Signature Required
  •