Pilgrim Lutheran Church 2021-2022 Faith Formation Registration
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Email *
Student First Name *
Student Last Name *
Preferred Name
Pronouns *
Required
Grade for 2021-2022 *
Student's School (if applicable)
Student Phone
Given the uncertainty of this coming year, we want to be in touch with changes to the schedule and flexible as we go. Update and reminder texts will be sent using the "Remind" app, does your student consent to receive these messages?" *
Required
Student Email
Caregiver #1 First Name *
Caregiver #1 Last Name *
Caregiver #1 Street Address *
Caregiver #1 City *
Caregiver #1 State *
Caregiver #1 Zip *
Caregiver #1 Phone *
Consent to receive "Remind" messages? *
Required
Caregiver #1 Email *
Caregiver #2 First Name
Caregiver #2 Last Name
Caregiver #2 Street Address
If caregivers 1 & 2 have the same street address, this section can be skipped.
Caregiver #2 City
Caregiver #2 State
Caregiver #2 Zip
Caregiver #2 Phone
Consent to receive Remind messages? *
Required
Caregiver #2 Email
Emergency Contact First Name *
Emergency Contact Last Name *
Emergency Contact Phone *
Emergency Contact Email *
Is your child interested in joining the children's choir? *
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