Children, Youth & Family Registration

PERMISSION STATEMENTS:

The form on this page will be considered your permission for your child to participate in all faith formation activities that are offered on and off site by First Lutheran Church for the 2025-2026 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).

Please complete for each child.(Required)

First Name

Last Name

Date of Birth

Is the Child Baptized?

Grade

Cell Phone (if available)

Tap the + to add additional children.

Parent/Guardian Name

First Last

Your Address(Required)

Street Address Address Line 2 City ZIP Code

Contact Phone(Required)

If "cell phone" indicate if text messages are okay

Other phone for main contact

If a land line is available enter here

Text Messages:

Yes

Your Email Address(Required)

Email Address Confirm Email Address

Alternative Contact(Required)

Please provide an emergency or an alternative contact if the primary contact in unavailable

Alternative Phone(Required)

Contact Relationship to:(Required)

Insurance/Medical

Insurance Company(Required)

Insurance Policy and/or Group Number(Required)

Medical/Health Notes (optional)

List any special medical conditions, allergies, or other medical information for each child.

Parents' Occupation or work hour considerations (optional)

List skills that might be helpful or work considerations that may affect a child's participation.

How Parents Can Help (check any and all you can do)

Snacks (sign-up on clip board in narthex)

Greet or usher at worship (sign-up on clip board in narthex)

Help on Tues or Weds (Julie will call you)

Clean/restock children's worship activity bags (Julie will call you)

Share your family's music talents in worship (Julie will call you)

Pray for Children, Youth & Family ministry

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