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Children's Sunday FAITH FORMATION
St. Mark's Lutheran Church by the Narrows Registration Form for 2015-2016
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* Indicates required question
Child's First Name
*
Your answer
Child's Last Name
*
Your answer
Date of Birth
MM
/
DD
/
YYYY
Child's Age
*
Your answer
Grade in Fall 2015
*
Your answer
School
*
Your answer
List any known environmental allergies
Your answer
List any known food allergies
Your answer
In a brief sentence, please describe what you would like us ti know about your child (including any health or developmental concerns):
Your answer
Is your child baptized?
Yes
No
Clear selection
Parent/s Name/s (first and last names)
*
Your answer
Address/es for mailing purposes:
Street
Your answer
Address/es for mailing purposes:
City
Your answer
Address/es for mailing purposes:
State
Your answer
Address/es for mailing purposes:
Zip Code
Your answer
E-mail address for primary contact:
Your answer
Facebook?
Yes
No
Clear selection
Primary Phone:
Your answer
Emergency Contact Name/Relationship
Your answer
Emergency Contact Phone Number:
Your answer
People, other than parent/s, authorized to pick up child/ren (children aged 3 through 2nd grade must be picked up by a parent or responsible designated person):
Your answer
Thank you!
If you have additional children to register for Sunday Faith Formation, please fill out another form. For additional children you need only to fill out the child's information and parent(s) name(s).
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