JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
B.L.A.S.T Wednesday Night Education Preschool-9th Grade
Grace Lutheran Church
4:45-6:15 Open Door Meal
5:40-6:30 Preschool-6th Grade Education Time
6:35 Worship
6:35-7:40 - 7th-9th Grade Confirmation
300 S Grant St
Fairmont MN 56031
507-238-4418
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Student’s Name
*
Your answer
Student’s Birthday
*
Your answer
Grade in the Fall 2021
*
Preschool (3 by September 1, 2021)
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
Required
Address
*
Your answer
City, State Zip Code
*
Your answer
Student's E-mail
Your answer
Student's Cell Phone Number
*
Your answer
Parent/Guardian's #1 Name
*
Your answer
Parent/Guardian's address (if different from child)
Your answer
Parent/Guardian's #1 City, State Zip Code (if different from child)
*
Your answer
Parent/Guardian's #1 Phone Number
*
Your answer
Parent/Guardian's #1 E-mail
*
Your answer
Parent/Guardian's #2 Name
Your answer
Parent/Guardian's #2 Address (if different from child's)
Your answer
Parent/Guardian's #2 City, State Zip Code (if different from child)
*
Your answer
Parent/Guardian's #2 Phone Number
Your answer
Parent/Guardian's #2 E-mail
Your answer
Emergency Contact
*
Your answer
Emergency Contact's Phone Number
*
Your answer
7th-9th Graders only... Who is your proposed confirmation Mentor?
Your answer
Where would you be willing to serve this year at Grace? Looking to have 4 team teachers per grade, so you can rotate every other week, month or whatever works for your group.
*
Preschool Team Teacher
Kindergarten Team Teacher
1st Grade Team Teacher
2nd Grade Team Teacher
3rd Grade Team Teacher
4th Grade Team Teacher
5th Grade Team Teacher
6th Grade Team Teacher
Storyteller
Substitute Teacher
Special Event Support
Tender Loving Children Team (Activities for children birth - 3 year old children)
Children, Youth & Family Team
Christmas Program Volunteer
Easter Program Volunteer
Family Fun Fair Coordinator
Activity Expo Coordinator
Confirmation Small Group Guide
Other:
Please share medical conditions including allergies, vision/hearing concerns, physical limitations, learning disabilities, or other special concerns etc.
*
Your answer
If my child needs medical treatment while participating, it is my wish that treatment be started while efforts are being made to contact me. I consent to medical procedures deemed necessary by the physician while efforts are continued to contact me. I accept responsibility for all cost related to such emergency treatment.
*
Yes
No
My child has permission to take part in all congregational activities, including off-site activities.
*
Yes
No
I give my permission to use pictures and the name of my child in publications from Grace Lutheran Church, which may include: bulletin boards, Ways of Grace, Grace website or local newspaper.
*
Yes
No
By checking this box and typing your name in below, you are stating that you are authorized to make decisions for the child listed above. Your digital signature on this form will be treated as a written one. Thank You. *
*
I am a parent/legal guardian for the child listed above.
Type in your Full Name and Date. Thank You!
*
Your answer
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
Forms
