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Faith Formation Registration
St. John's Lutheran Church
1403 Newman St., Bloomer, WI 54724
715-568-5446
Registration for ALL Faith Formation groups (JAM, Confirmation, and Youth in Action)
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Today's Date
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Parent(s)/Guardian(s)
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Your answer
Address
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Your answer
Cell Phone
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Your answer
Can Pastor Martin or Amanda Ritchie text this phone number to send reminders, upcoming events to be aware of, or other church/ministry related reasons?
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Yes
No
Secondary Phone
Your answer
Email Address
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Your answer
Emergency Contact (other than parent/guardian)
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Your answer
Emergency Phone
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Your answer
List all authorized people to whom my child(ren) may be released:
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Your answer
Can we use pictures taken of Sunday/Wednesday activities for promotional events, on our website, or on our Facebook page?
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Yes
No
Which day will your child participate? (Note: Sunday is Pre-K-3rd Grade, Wednesday is Pre-K-8th Grade)
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Sunday
Wednesday
Can Pastor Martin or Katie O'Connell text your child(ren) to send reminders, upcoming events to be aware of, or other church/ministry related reasons?
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Yes
No
Child 1's Name
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Your answer
Child 1's Birth Date
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Child 1's Grade
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Pre-K: 3 year old
Pre-K: 4-5 year old
Kindergarten
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Child 1's Allergies/Medical Information
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Your answer
Child 1's Cell Phone (if applicable)
Your answer
Child 2's Name
Your answer
Child 2's Birth Date
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YYYY
Child 2's Grade
Pre-K: 3 year old
Pre-K: 4-5 year old
Kindergarten
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Child 2's Allergies/Medical Information
Your answer
Child 2's Cell Phone (if applicable)
Your answer
Child 3's Name
Your answer
Child 3's Birth Date
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YYYY
Child 3's Grade
Pre-K: 3 year old
Pre-K: 4-5 year old
Kindergarten
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Clear selection
Child 3's Allergies/Medical Information
Your answer
Child 3's Cell Phone (if applicable)
Your answer
Child 4's Name
Your answer
Child 4's Birth Date
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DD
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YYYY
Child 4's Grade
Pre-K: 3 year old
Pre-K: 4-5 year old
Kindergarten
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Child 4's Allergies/Medical Information
Your answer
Child 4's Cell Phone (if applicable)
Your answer
Child 5's Name
Your answer
Child 5's Birth Date
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DD
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YYYY
Child 5's Grade
Pre-K: 3 year old
Pre-K: 4-5 year old
Kindergarten
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Child 5's Allergies/Medical Information
Your answer
Child 5's Cell Phone (if applicable)
Your answer
Child 6's Name
Your answer
Child 6's Birth Date
MM
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DD
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YYYY
Child 6's Grade
Pre-K: 3 year old
Pre-K: 4-5 year old
Kindergarten
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2
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12
Clear selection
Child 6's Allergies/Medical Information
Your answer
Child 6's Cell Phone (if applicable)
Your answer
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