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. Child's InformationPlease fill out a form for EACH child you are registering. Which Ministry are you signing up for? Early Childhood Ministry - Ages 3 to Kindergarten Elementary Youth Ministry - Grades 1 to Gr. 5 Confirmation - Grade 6, 7, 8 Confirmation - Grade 9 Youth Ministry - Grade 6 to 12 Please check specific program(s) Sunday - Sunday School (Ages 3 - Grade 12, Sun. 9:30-10:15) Wednesday Children's Elem (Grade 1 - 5, 3:30-4:45) Release Time (Wed. morning, Gr 2-5) MAP (2 hr late start, Gr 1-5) NEW! THREE18 (H.S. Youth Group, Wed. 6:15-7:45) Child's Name First Last Child's Birth Date Date Format: MM slash DD slash YYYY GradePlease enter the grade the child is currently in, or will be entering when school resumes in the fall. Child's Baptism Date Date Format: MM slash DD slash YYYY 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 SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands 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?CommentsThis field is for validation purposes and should be left unchanged.
