EmailMe Form - Youth Overnight Lock In

Child's Name *
Child's Age *
I give my child (named above) permission to attend the May 10th & 11th overnight lock-in at Trinity Lutheran Church in Gresham, Oregon
Parent/Guardian's Name *
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Email *
Phone *
### - ### - ####
Church Affiliation *
Emergency Contact
enter name & Phone number for emergency contact(s)
Name *
First Last
Phone *
### - ### - ####
Name *
First Last
Phone *
### - ### - ####