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Adult Registration
Faith Lutheran Adult Registration
This needs to be filled out and approved before working with any of our children or minors at a Faith sponsored event if you plan to be alone with children at anytime without their legal guardian present
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* Indicates required question
Full name
*
Your answer
Phone Number
*
Your answer
Address
Your answer
Email Address
*
Your answer
Emergency Contact person, phone number, and relation
*
Your answer
Health plan and group number
*
Your answer
Do we have permission to run a background check on you?
*
Yes
No
If yes, provide your maiden name and/or any and all aliases
Your answer
Date of Birth
MM
/
DD
/
YYYY
Place of birth
Your answer
Driver's License Number and State issued
Your answer
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