Register Your Child - Faith Lutheran Church

Child's Name Child's Name First Last
Who does the child live with?
Child's Birth Date Child's Birth Date / MM / DD YYYY
Grade
Baptism Date Baptism Date / MM / DD YYYY

(If not baptized, leave blank)
Primary Phone Number Primary Phone Number - ### - ### ####
Parent Email

Please enter an email that you check regularly
Home Address Home Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Parent Name 1 Parent Name 1 First Last
Parent Name 2 Parent Name 2 First Last
How did you hear about the Children's Ministry at Faith?
Allergies, Medical Conditions, Special Needs, etc.
Instructions for Emergency

In the case of a lost security wristband, my child may be released to the parents above OR one of the following people.
Name and Phone of Emergency Contact
Pictures

During Nursery and/or ReachKidz we take photos and video of our children to post on Faith's website and social media pages (no names). May we include your child in our photos/videos? Please select your preference.
Photos?