Sunday School, 56 Club, & Confirmation Registration 2024 -2025 Interested in signing a child up for Sunday School, the 56 Club, or Confirmation? Fill out this form and we will be in touch shortly! Family Last Name * Guardian 1 * Guardian 2 Child's Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Guardian 1 Phone Number * (###) ### #### Permission to text this number? * Yes No Guardian 1 Email Address * Guardian 2 Phone Number (###) ### #### Permission to text this number? Yes No Guardian 2 Email Address * Who does the child live with? Who is the primary contact person for the child? Are you a member of Ezekiel? Yes No Interested in Membership? Yes No Child(ren) baptized? Yes No If no, are you interested in learning about baptism? Yes No Has your child(ren) had First Communion? Yes No EMERGENCY CONTACT: In the event a guardian can't be reached in case of emergency, who else could we contact? * Please enter first name, last name, and phone number Child 1 * First Name Last Name Child 1 Date of Birth * MM DD YYYY Child 1 Age Child Which program are they registering for? Sunday School for PreK-4th Grade 56 Club 7th & 8th Grade Confirmation 9th Grade Confirmation Child 2 First Name Last Name Child 2 Date of Birth MM DD YYYY Child 2 Age Child 2 Grade Child 2 Which program are they registering for? Sunday School for PreK-4th Grade 56 Club 7th & 8th Grade Confirmation 9th Grade Confirmation Child 3 First Name Last Name Child 3 Date of Birth MM DD YYYY Child 3 Age Child 3 Grade Child 3 Which program are they registering for? Sunday School for PreK-4th Grade 56 Club 7th & 8th Grade Confirmation 9th Grade Confirmation Child 4 First Name Last Name Child 4 Date of Birth MM DD YYYY Child 4 Grade Child 4 Which program are they registering for? Sunday School for PreK-4th Grade 5 Club 7th & 8th Grade Confirmation 9th Grade Confirmation Child Concerns (For each child please indicate any health issues, allergies, medications, medical concerns, learning and/or behavioral concerns, or anything else we should be aware of.): * Parent Agreement: If I am in attendance, I agree to be inlvolved actively in the supervision of all children. If I observe any unsafe or disrespectful behavior, I will take the time necessary to provide the needed guidance and adult supervision. My overall goal is the safety and Christian education of all children. I will keep this ministry in my prayers. I, the parent/guardian of the child(ren) listed above, hererby authorize a representative of Ezekiel Lutheran Church to authorize emergency healthcare for my child(ren) if necessary. I, hereby authorize the staff and/or volunteers of Ezekiel Lutheran Church Confirmation Programs to take my son/daughter on a field trip which is part of this education program. I hereby hold the staff and/or volunteers of Ezekiel Lutheran Church harmless for any injury or harm that my son/daughter may incur while participating in these programs, a related field trip, or service project of the said programs. Field Trips are always planned in advance and parents are given notice as to when they are happening. For off site activities without a parent present, there will be a healthcare form to complete. Typing your name below will act as your signature to this agreement. Note: Photos of activities and events are occasionally used for publication on our website, brochures, newsletters, etc. Yes, you have permission to use photos of my child. No, you do not have permission to use photos of my child. Thank you!We look forward to your family joining in on Ezekiel’s children and youth programming. Please Contact Marci or Allson if you have any additional questions.
