2022-2023 Christian Ed Registration - Immanuel Trinity Lutheran Church

Child's Information

Child's First Name, Middle Initial, Last Name *

Birthdate *

Age *

Last Grade Completed *

Allergies/Medical Information/Other: *

Parent Guardian #1 Information

Parent/Guardian Name #1 *

Parent/Guardian #1 Cell Phone # *

Parent/Guardian #1 Home Phone # *

Parent/Guardian #1 Address *

Address 1
Address 2

City

State

Zip

Parent/Guardian #1 Email Address *

Parent Guardian #2 Information

Parent/Guardian Name #2 *

Parent/Guardian #2 Cell Phone # *

Parent/Guardian #2 Address *

Address 1
Address 2

City

State

Zip

Parent/Guardian #2 Email Address *

Emergency Contact Information

Emergency Contact Name *

Emergency Contact Phone # *

Picking Up Your Child From school

Parents must come into the church to pick up your child when School is done. This is to ensure the safety of all children in the Program.

Name of Person Who Will be PIcking up the Child *

Phone # of Person Who Will be PIcking up the Child *

Photo Permission

Immanuel-Trinity Lutheran Church, Fond du Lac, WI may include images on our website, brochures, or other forms of media to promote the positive activities happening at our church. Names will never be used on the site to directly identify youth. Please indicate your preference below.

Photo Permission * (1 required)

Yes, I give permission for Immanuel-Trinity Lutheran Church to use a photograph/image of my child No, I do not give permission.

PARENTS WE NEED YOUR HELP!

The success of our Sunday School Program depends on our volunteers. The areas how you can contribute your gifts God has given you could be :

Teach, Be a Chaperone Kids and Assist Teachers, Donate Supplies, Play a Musical Instrument, Prepare Food for Special Events, Join The Christian Education Committee.

I am Interested in Helping with Activities * (1 required)

Yes No

Enter Your Email Address: *