Grace Lutheran Church Sunday School Registration

GLOW 2024-2025 Registration

Youth grades 5, 6 & 7. We at Grace want to help youth grow in faith and live as disciples of Jesus and to help build and strengthen relationships with God and with one another.
Please complete and submit the following to register your child for GLOW. If you would like a paper copy mailed to you, please contact Patti Gaedtke at 715-612-2000 or email at glcglow@gmail.com.
Youth/Family Information
Child's Name

First NameMiddle NameLast Name
Age
Date of Birth

MonthDayYear
Grade
Baptism Date

MonthDayYear
Parent/Guardian #1

First NameLast Name
Parent/Guardian #2

First NameLast Name
Phone Number

(Home, Mom, Dad, etc) Phone Number
Phone Number

(Home, Mom, Dad, etc) Phone Number
Phone Number

(Home, Mom, Dad, etc) Phone Number
E-mail
E-mail
example@example.com
Address 1

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Address 2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Medical Information

NOTE: Every minor attending a Grace Lutheran event must have this Medical Release Permission Form. The Grace staff/group leader/chaperone will keep a copy during the entire event.
Name of Participant

First NameLast Name
Parent/Guardian

First NameLast Name
Parent/Guardian

First NameLast Name
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Medical Insurance Company Name
Name of Policy Holder
Medical Insurance Policy Number
Group Number (if applicable)
Medications being taken/dosage/frequency
List ALL Allergies
Date of last tetanus shot

MonthDayYear
Date
Please include any medical or learning information that may influence your child's time with us at GLOW.

Permission to Publish

Photo/Video Image Release
We like to take photos and/or videos of the youth in action and would request permission to publish such photos/videos which contain your child’s image, on the church website, big screens at worship services, church Facebook page, and/or our church newsletter. If you DO NOT consent to the release of your child's image, please note that in the "comments" section below.
Parent Signature
By signing and submitting this registraiton form, you understand and agree to all policies.
Parent/Guardian Signature*

First NameLast Name
Today's Date*

MonthDayYear
Date
Comments and/or Questions:
Should be Empty:

GLOW 2024-2025 Registration