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2023-2024 Sunday School Registration Form
Ages Pre-K through 6th Grade
St. John ELCA
5304 N. 44th Avenue
Wausau, WI 54401
715-675-6950
Questions? Contact Kim Landwehr (kamootz@gmail.com)
Name - Child 1
First
Last
Name - Child 2
First
Last
Name - Child 3
First
Last
Date of Birth - Child 1
MM
/
DD
/
YYYY
Grade (2023-2024) Child 1
Date of Birth - Child 2
MM
/
DD
/
YYYY
Grade (2023-2024) Child 2
Date of Birth - Child 3
MM
/
DD
/
YYYY
Grade (2023-2024) Child 3
Address
Street Address
City
State / Province / Region
Postal / Zip Code
Home Phone
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####
Work Phone
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####
Cell Phone
###
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Home Email Address
In Case of Emergency, Contact:
Emergency Contact Relationship to Child
Phone Number of Contact
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Parents'/Guardian Names
Others allowed to pick up my child
Known allergies or other medical conditions:
Image Consent
Yes, I hereby give consent for my child to have his/her picture taken and displayed in the church and/or on St. John's website.
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