Registration Fee: $20/student ($40 max per family)
Please make check payable to Grace Lutheran Church
Student's Full Name:
Address:
City:
State:
Zip Code:
Home Phone:
Cell Phone:
Birthdate:
Grade:
Baptized:
yes no
Mother's Name:
Father's Name:
Emergency Contact:
Parents are:
Members Attendees Visitors
Email Address:
I give permission to have my child's picture taken to possibly be used on the Grace website:
Yes No
Saturday, 5pm Sunday, 9am Sunday, 10:20am
Special needs your child has that teacher should be aware of: