Sunday School Registration Form

Please complete the following form to enroll your child in Emmanuel Lutheran’s Youth Sunday School Program

If you prefer you may print out a copy of the registration form here and submit it to the Church Office

Student's Name (Required Field) *

Street Address (Required Field) *

City/State/Zip (Required Field) *

Home Phone Number: (Required Field) *

Student's Date of Birth (Required Field) *

Please indicate which class your child will be entering this fall: (Required Field) *

Please advise age if the child is entering Pre-K:

Parent/Guardian Name (Required Field) *

Relationship (Required Field) *

Parent/Guardian's Cell Phone Number (Required Field) *

Parent/Guardian's Email Address (Required Field) *

Parent/Guardian's Street Address (if different from student)

Parent/Guardian's City/State/Zip (if different from student)

Additional Parent/Guardian's Name (If Applicable)

Parent/Guardian's Relationship to Student

Parent/Guardian's Cell Phone Number (If Applicable)

Parent/Guardian's Email Address (If Applicable)

Parent/Guardian's Street Address (if different from student)

City/State/Zip (if different from student)

Emergency Contact Name (Required Field) *

Emergency Contact Relationship (Required Field) *

Emergency Contact Phone Number (Required Field) *

Known Allergies/Special Needs:

Medications:

Emmanuel Lutheran Church Website Photo Release: (Required Field) *

Grants permission to Emmanuel Lutheran Church to use images of the youth named on this form on the Emmanuel Website

Emmanuel Lutheran Church Facebook Photo Release: (Required Field) *

Grants permission to Emmanuel Lutheran Church to use images of the youth named on this form on the Emmanuel Facebook Page

Parent/Guardian's Name Who is Giving Photo Permission (Typing in your name will serve as your signature) (Required Field) *

Parent/Guardian's Email (Required Field) *

Date Signed (Required Field) *

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