M.A.D. Club 2021-2022 Registration
$20 Per kiddo for two semesters of snacks and a t-shirt :) YAY!! Please send money to St. John Lutheran of Bellville.
Sign in to Google to save your progress. Learn more
Agape League
Child's First & Last Name: (Please fill out new form for each additional kiddo) *
Age & Grade: *
Gender: *
Name of school: *
Will they need a ride with the church?: *
Address: *
Telephone number for TEXT & calls: *
Parents Name: *
Parents Email: *
Secondary Adult Name & Phone Number for Emergencies: *
Food Allergies (please list none, if there isn't any): *
T-Shirt Size: *
The child registered on the form have my permission to participate in St. John's Youth Outreach Ministries, during indicated sessions. I agree that St. John Lutheran Church and/ or the ELCA will not be held responsible for accidents arising thereof. I am responsible for any medical obligations incurred during these activities and give the St. John Lutheran Church permission to seek treatment in case of injury or illness. I give permission for St. John Lutheran Church, the ELCA to use, publish or disclose in newsletters, brochures, periodicals, posters, website or other media-related vehicles any photographs, videos, audios, or other material in which my child may have appeared, spoken, written or otherwise been represented. I understand that I am ultimately responsible for my child's behavior at Church and that they will be expected to live by the Youth Covenant which states: "I will show respect for God, others and myself." I know that violation of this covenant can and will result in my child being removed from the program. *
I will send $20 with my child for snack, t-shirt & play rights. *
Our program for 2022!! So exciting!
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy