JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Child/Youth Faith Formation Registration 2021-2022
Registration for Faith Formation at Lakewood Congregational Church (United Church of Christ), 1375 West Clifton Blvd., Lakewood, Ohio 44107
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Child's First and Last Name
*
Your answer
Child's Pronouns
*
they/them
she/her
he/him
Other:
Required
Best email addresses for communication from the church. (You may list more than one)
*
Your answer
Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Child's Birth Date
*
MM
/
DD
/
YYYY
Grade/LCC Class (2021/2022):
*
Nursery (infant-3 years old)
Pre-school/Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
For children/youth in Preschool-5th grade, please choose your release option. (for in-person events)
Adult or youth will pick up from the nursery or classroom
Child/youth may be released to self
Clear selection
For children being picked up in the nursery or classroom, please list adults/youth (6th-12th grade) permitted to pick child up.
Your answer
Please list if your child has allergies.
Your answer
Please list any accommodations we can make to help your child have a positive experience.
Your answer
Please list anything additional that you'd like us to know about your child or family.
Your answer
Adult #1 (first and last name)
*
Your answer
Adult #1 Cell Phone Number
*
Your answer
Adult #1 Relation to Child
*
Your answer
Adult #2 (first and last name - N/A if does not apply)
*
Your answer
Adult #2 Cell Phone Number
Your answer
Adult #2 Relation to Child
Your answer
I give Lakewood Congregational Church permission to photograph my child/youth. Photos could be used within church and through church publications, printed and digital.
*
Yes
No
Parent/Guardian Signature: by typing your name below, you agree that all information in this form is correct and that you give permission for the child/youth listed to participate in Faith Formation/Children & Youth activities through Lakewood Congregational Church.
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Lakewood Congregational Church.
Report Abuse
Forms
