Thanks for your interest in Ministry at Peace Lutheran Church! Please fill out of the following information and we will be in touch with you soon. Which Ministry are you signing up for? Early Childhood Ministry - Ages 3 to Kindergarten Elementary Youth Ministry - Grades 1 to Gr. 5 Youth Ministry - Grade 6 to 12 Confirmation - 6, 7, 8 Grade Please check specific program(s) Sunday School (Ages 3 - Grade 8) Elementary Youth (Wed. 3:30-4:45, Gr 1-5) Release Time (Wed. morning, Gr 2-5) MAP (2 hr late start, Gr 1-5) Prayz Team (Gr. K-12) "Recharge" (Wed. 2:30-5:30, Gr 6-8) High School Bible Study (Wed. 6:15-7:45, Gr 9-12 Child's InformationPlease fill out a form for EACH child you are registering. Child's Name First Last Child's Birth Date GradePlease enter the grade the child is currently in, or will be entering when school resumes in the fall. Child's Baptism Date Does this child have any allergies or medical concerns?YesNoIf yes, please explainParent/Guardian InformationParent/Guardian NamePlease enter the parent or guardian's name/s Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone*Email* Member of Peace?YesNoIf no, would you like info on becoming a member?Alternate ContactAlternate Contact Name First Last At times, we need to have an alternate contact to get a hold of. Please fill in that information here. Alternate Contact PhonePlease enter a phone number for the alternate contact.Photographer WaiverPlease enter your initialsBy entering your initials in the box below, you hereby grant Peace Lutheran Church leaders permission to photograph/film the minor(s) designated above in any manner or form for any lawful purpose associated with this Peace Lutheran Church program.OtherOther comments:Please use this area to provide information that you think we should know about this child. CAPTCHA*What is 10+22?EmailThis field is for validation purposes and should be left unchanged.
