EmailMe Form - Faith Lutheran Church - Sunday School and Midweek

Parent Information

Please enter the following information for the parents.

Parent 1 Name *

First Last

Cell Phone - Parent 1 *

### - ### - ####

Parent 1 Email

The best way to contact me is via: *

Phone call

Text

Email

Select one or more

Parent 2 Name

First Last

Cell Phone - Parent 2

### - ### - ####

Parent 2 Email

The best way to contact me is via:

Phone call

Text

Email

Select one or more

Parent 1 Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Parent 2 Address

Same as above

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Student Information

Please enter the following information for your student(s).

Student 1 Name (First Last): *

Student 1 Grade: *

Student 2 Name (First Last):

Student 2 Grade:

Student 3 Name (First Last):

Student 3 Grade:

Student 4 Name (First Last):

Student 4 Grade:

Please list any allergies for your student(s):

Enter the student name followed by the allergy

Emergency Contact Name *

First Last

Emergency Contact Phone *

### - ### - ####

Permissions - Photograph and First Aid

I/We give permission for pictures of my/our student(s) to be used on the church website and in other publications of the church.

I/We give permission for the teachers or administrators to give my/our student(s) over-the-counter (OTC) medication and/or First Aid as the need should arise.

I/We are registering for: *

Sunday School (Sundays at 9:45AM)

Midweek classes (Wednesdays at 6:30PM)

Select one or both.