7th-9th Grade Registration Form

School Year 2017/2018
Grades 7,8 and 9. Registration Fee: $40 per child.

Child's Name * First Last
Birth Date * / MM / DD YYYY
Grade in School:
Child #2 Name First Last
Birth Date / MM / DD YYYY
Grade in School:
Child #3 Name First Last
Birth Date / MM / DD YYYY
Grade in School:
Additional Children:

Please list name, birth date and grade of any additional children you would lie to register.
Parent Name(s)
Home Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Home Phone - (###) - ### ####
Member of Family of Christ? Yes No
Home Email
Mom Cell: - (###) - ### ####
Dad Cell
- (###) - ### ####
Emergency Contact * First Last
Emergency Contact Phone * - (###) - ### ####
Allergies

Please list any allergies and the name of the child the allergy pertains to.
Family of Christ Lutheran Church has my permission to take photographs and/or video of my child(ren) participating in church activities, and to use those photos/videos for the purposes of promoting Family of Christ programs and ministries. * Yes No