Prince of Peace Lutheran Church

2023-24 PoP Faith Formation Registration (3K - 5th Grade)

Please complete sections to the best of your ability. Items marked with an * are required. Please register by Sunday, 9/3/23. Kickoff is on Sunday, 9/10/23. If you have any questions, please reach out to Barbara at barbara@popappleton.org.

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You will receive an e-mail confirming Faith Formation registration upon submission.

YOUTH SECTION: We ask that you register your child/children annually, and a registration form for each individual child attending needs to be completed. Thank you.

Child's Name *


First Name	Last Name

Middle Name:

Preferred Nickname (if applicable)

Primary Residence/Address *


Address

Address Line 2

City	State	Zip Code

If alternate address also applies, please share here:

Birth Date *

Has your child been baptized?

Select one

Yes
No

Name of Current School attending for 2023-24 year (List 'Home' if home schooled)

Grade (2023-24) *

Is child a PoP Member? (Note, membership is not required to participate in Faith Formation)

Select one

Yes
No
They would be interested in receiving membership information

Please list other siblings also enrolling & grades as applicable

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) *


First Name	Last Name

Parent/Guardian Phone Number(s) (Please note if cell (C) or home landline (H) by person) *

Parent/Guardian Email Address(es)

Are Parents/Guardians members of Prince of Peace? (Note, membership is not required to participate in Faith Formation)

Select one

Yes
No
I/We are interested in receiving membership information

Additional Emergency Contact if Parent/Guardian unavailable (Name/Phone #/Relationship to child) *

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

Yes
No

Please indicate any food allergies or other medical restrictions/conditions we need to be aware of. If none, type "none": *

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:

Volunteer Opportunities - I am interested in being a part of the Faith Journey of our children at Prince of Peace:

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 all that apply

Faith Formation Teacher
Helper
Other
None of the above

I am available to volunteer (please check all that apply):

Select all that apply

Please provide names of parents who are interested in volunteering:

By submitting this form, I grant permission to Prince of Peace Lutheran Church to use my child's likeness/pictures/videos in church promotional materials & communications. I agree to contact Barbara or other PoP staff if I want to opt out from this.

Signature of a Parent/Guardian (Type in name to confirm registration of the above child) *

Today's Date *

* required