MLC Youth Registration Form

Child 2 Information
C2-First Name
C2-Last Name
C2-Current Grade
C2-Birthday

MonthDayYear
Date
C2-School Attending
C2-Baptism Month
Participation: Please check any activities below that your child may be participating in this year. This helps us reach out to you as these activities are scheduled. For information about MLC's Youth Programming, please visit www.mlutheran.org/education.
C2- MLC Activity Participation (check all that apply)*

Sunday School (Gr. Pre-K to Gr. 12)First Communion Instruction (ages 7+)Acolyte Training (Grade 4+)Confirmation Classes (Typically Grade 8 & 9)Youth Fellowship Programming (MOES, Jr. & Sr. Youth)Youth Music Programming (Cherub, Seraph Choirs)
Medical / Dietary / Special Concerns: If your child has a medical, behavorial, dietary, or learning condition that is important for us to know while they are in the care of MLC leaders, please briefly summarize them below and we will follow up with you. If no significant concerns exist, please write "None" in the box below.
C2- Concerns or Conditions *
We will reach out to you for specifics on your child's concerns and work with you on making the Sunday School time safe and rewarding for your child.
Do you have additional children to register?

YesNo

Child 3 Information
C3-First Name
C3-Last Name
C3-Current Grade
C3-Birthday

MonthDayYear
Date
C3-School Attending
C3-Baptism Month
Participation: Please check any activities below that your child may be participating in this year. This helps us reach out to you as these activities are scheduled. For information about MLC's Youth Programming, please visit www.mlutheran.org/education.
C3- MLC Activity Participation (check all that apply)*

Sunday School (Gr. Pre-K to Gr. 12)First Communion Instruction (ages 7+)Acolyte Training (Grade 4+)Confirmation Classes (Typically Grade 8 & 9)Youth Fellowship Programming (MOES, Jr. & Sr. Youth)Youth Music Programming (Cherub, Seraph Choirs)
Medical / Dietary / Special Concerns: If your child has a medical, behavorial, dietary, or learning condition that is important for us to know while they are in the care of MLC leaders, please briefly summarize them below and we will follow up with you. If no significant concerns exist, please write "None" in the box below.
C3- Concerns or Conditions *
We will reach out to you for specifics on your child's concerns and work with you on making the Sunday School time safe and rewarding for your child.
Do you have additional children to register?

YesNo

Child 4 Information
C4-First Name
C4-Last Name
C4-Current Grade
C4-Birthday

MonthDayYear
Date
C4-School Attending
C4-Baptism Month
Participation: Please check any activities below that your child may be participating in this year. This helps us reach out to you as these activities are scheduled. For information about MLC's Youth Programming, please visit www.mlutheran.org/education.
C4- MLC Activity Participation (check all that apply)*

Sunday School (Gr. Pre-K to Gr. 12)First Communion Instruction (ages 7+)Acolyte Training (Grade 4+)Confirmation Classes (Typically Grade 8 & 9)Youth Fellowship Programming (MOES, Jr. & Sr. Youth)Youth Music Programming (Cherub, Seraph Choirs)
Medical / Dietary / Special Concerns: If your child has a medical, behavorial, dietary, or learning condition that is important for us to know while they are in the care of MLC leaders, please briefly summarize them below and we will follow up with you. If no significant concerns exist, please write "None" in the box below.
C4- Concerns or Conditions *
We will reach out to you for specifics on your child's concerns and work with you on making the Sunday School time safe and rewarding for your child.
Do you have additional children to register?

YesNo

Child 5 Information
C5-First Name
C5-Last Name
C5-Current Grade
C5-Birthday

MonthDayYear
Date
C5-School Attending
C5-Baptism Month
Participation: Please check any activities below that your child may be participating in this year. This helps us reach out to you as these activities are scheduled. For information about MLC's Youth Programming, please visit www.mlutheran.org/education.
C4- MLC Activity Participation (check all that apply)*

Sunday School (Gr. Pre-K to Gr. 12)First Communion Instruction (ages 7+)Acolyte Training (Grade 4+)Confirmation Classes (Typically Grade 8 & 9)Youth Fellowship Programming (MOES, Jr. & Sr. Youth)Youth Music Programming (Cherub, Seraph Choirs)
Medical / Dietary / Special Concerns: If your child has a medical, behavorial, dietary, or learning condition that is important for us to know while they are in the care of MLC leaders, please briefly summarize them below and we will follow up with you. If no significant concerns exist, please write "None" in the box below.
C4- Concerns or Conditions *
We will reach out to you for specifics on your child's concerns and work with you on making the Sunday School time safe and rewarding for your child.
Do you have additional children to register?

YesNo

Almost Done!

Please review the following questions before you submit your registraiton.
Would you or other parent/guardians be willing to serve as a Sunday School Substitute Teacher if the need arose?

Yes.Not sure but would consider it. Depends on what grade level.No.
Is one or more of your children (3rd grade and older) interested in receiving a bible from MLC?

YesNo

Authorized Individuals: MLC leaders will only release children to the parent or guardians listed above. If there are other individuals permitted to pick up your children at the conclusion of an activity, please list their full names and relationship to children here.
We will reach out to you for specifics on your child's concerns and work with you on making the Sunday School time safe and rewarding for your child.
Please include any other important information about your children below. If necessary we will follow up with you personally.
Photo Release: I understand that during church related activities pictures may be taken of my child to record and capture the event taking place. I give permission for my child’s image to appear in church publications such as, but not limited to, the church newsletter, member e-newsletters, website, online galleries, livestream, etc. MLC staff and youth leaders will not take individual photos of minors, or identify by name children in photos, except for making things like internal class rosters (or posters), craft projects, etc.
Photo Release*

I consent to the Photo Release as written aboveOther
Participation Consent: I give permission for my child(ren) to participate fully in Youth and Education programing at Messiah Lutheran Church, including classroom activities, worship activities, games, snacks, and on site recreation activities. I give permission for my child to participate in any off site programming where I provide transportation to the activity for my children, or my children provide their own transportation.

Medical Treatment Authorization:
I understand that I will be notified in case of a medical emergency involving my child. However, in the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event my child is injured or becomes ill. I understand that the church will not be responsible for medical expenses incurred, but that such expenses will be my responsibility as
parent/guardian.

I agree to notify the church in the event of any health changes which would restrict my child’s participation in any normal youth or children’s activities.

I also understand that the adult supervisors reserve the right to restrict my child from any activities that they do not feel are within the physical capabilities of my child.
Physician / Clinic Name
Physician/Clinic Phone Number
Please sign with your finger or mouse that you have read the above and give permission for your child to participate in Sunday School and other MLC activities.

Clear
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Messiah Lutheran Church - Youth and Education Registration Form

Child 1 Information

Child 2 Information

Child 3 Information

Child 4 Information

Child 5 Information

Almost Done!