Prince of Peace Lutheran Church
2020-21 Faith Formation Registration
Please complete sections to the best of your ability, items marked with an * are required; if you have questions, please contact Anna or Brigetta at 739-5255. Please register by Sept. 1st as classes begin September 8th.
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YOUTH SECTION: Please use a separate form for each child you are registering
Student's Name *
required
First Name
Last Name
Middle Name:
required
Preferred Nickname (if applicable)
required
Primary Residence/Address *
Address
Address Line 2
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Marshall Islands
Micronesia
Northern Marianas
Palau
Puerto Rico
Trust Territories
Virgin Islands
Armed Forces(AA)
Armed Forces(AE)
Armed Forces(AP)
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territory
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
City
State
Zip Code
If alternate address also applies, please share here:
required
Birth Date *
required
Baptismal Date (& Church Location if not baptized at Prince of Peace)
required
Name of Current School Attending for 2020-21 year (List 'Home' if home schooled)
required
Grade (2020-21) *
required
Is Child a PoP Member? (Note, membership is not required to participate in FF)
select one
Select one
Yes
No
He/she would be interested in receiving membership information
Please list other siblings also enrolling & grades as applicable
required
Parent/Guardian Contact Information (can include both parents' first names in "first name" section; or if different last names, list one parent in first box and second parent in second box ) *
required
First Name
Last Name
Parent/Guardian Phone Number(s) (Please note if cell (C) or home landline (H) by person) *
required
Parent/Guardian Email Address(es)
required
Are Parents/Guardians members of Prince of Peace? (Note, membership is not required to participate in FF)
select one
Select one
Yes
No
I/We are interested in receiving membership information
In Case of a Medical Emergency, I give the staff of Prince of Peace Lutheran Church permission to treat my child until a Parent/Guardian can be reached. *
select one
Select one
Yes
No
Additional Emergency Contact if Parent/Guardian unavailable (Name/Phone #/Relation to child)
required
My child has access to the internet for virtual classtime:
select one
Select from list
Yes
No
I give permission for my child to participate in Zoom classtime for Faith Formation:
select one
Select from list
Yes
No
Please indicate any food allergies or other medical restrictions/conditions we need to be aware of:
required
Please use this space to list any special educational needs (learning challenges, behavioral concerns etc.) and/or additional information you feel is relevant for PoP Staff to be aware of:
required
Volunteer Opportunities - I am interested in being a part of the Faith Journey of our children at Prince of Peace.
select one
Select one
Yes
No
Maybe - I would like more information
I would specifically like to help in the areas of(check all that apply)
select one
Select all that apply
Faith Formation Teacher
Helper
Other
None of the above
I am available to volunteer (please check all that apply)
select one
Select all that apply
Every Week
Every other week
AS needed
For Special Events like PoP Camp and the Christmas Program
None of the above
Please provide names of parents who are interested in volunteering.
required
PHOTO/VIDEO RELEASE: I grant permission to Prince of Peace Lutheran Church and it's representatives to use my child's likeness/picture in church promotional materials & communications (e.g. newsletter, bulletin boards, website, social media etc.) *
select one
Select one
Yes
No
Signature of a Parent/Guardian (Type in name to confirm registration of the above youth). *
required
Today's Date *
required
* required