Sunday School Youth Information
Please fill out this form and click submit.
Youth Name #1
*
Date of Birth
*
Grade (3yrold/PreK - 5)
*
Youth Name #2
Date of Birth
Grade (3yrold/PreK - 5)
Youth Name #3
Date of Birth
Grade (3yrold/PreK - 5)
Youth Name #4
Date of Birth
Grade (3yrold/PreK - 5)
Youth Name #5
Date of Birth
Grade (3yrold/PreK - 5)
Household Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Parent/Guardian Name #1
*
Phone
*
Email
*
This address will receive a confirmation email
Interested in Volunteering (ex: Christmas Program; Special Sundays or Events; Classroom help; Misc.)
*
Please select one option.
Yes
No
Maybe
Parent/Guardian Name #2
Phone
Email
Interested in Volunteering (ex: Christmas Program; Special Sundays or Events; Classroom help; Misc.)
Please select one option.
Yes
No
Maybe
Emergency Contact Name (Non-Parent/Guardian)
*
Phone
*
Please list any known allergies and/or any information that may be helpful for our leaders
PHOTO RELEASE: Bethlehem Lutheran Church of Brainerd has my permission to use my or my youth’s photograph publicly to promote the church and its programs. I understand that the images may be used in print publications, online publications, presentations, websites and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.
*
Please select all that apply.
Yes
No
Submit
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