Children's/Youth Registration 24/25 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. Please check each specific Ministry program(s) Select All Sunday - Sunday School (Ages 3 - K) 9:40-10:25) Sunday - Sunday School (Gr 1 - 5) (9:40-10:25) Sunday - Sunday School (Gr 6 - 12) (9:40-10:25) Release Time Wed. morning (Gr 2 - 5) School forms must also be filled out to be released from school. Confirmation (Grade 6) Wed. 2:40-4:15 Confirmation (Grade 7 - 8) Wed. 2:45-4:15 Tiger Tweens (grades 4-5) Wed 3:20 Child's Name First Last Child's Birth Date* MM slash DD slash YYYY Grade*Please enter the grade the child is currently in, or will be entering when school resumes in the fall. Child's Baptism Date MM slash DD slash YYYY Does this child have any allergies or medical concerns? Yes No If 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 FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* Member of Peace?* Yes No If 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 initials*By 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.Other comments:Please use this area to provide information that you think we should know about this child. PhoneThis field is for validation purposes and should be left unchanged. Δ
