Christmas for Kids
at Christ Lutheran Church, Lodi on Saturday, December 14 @ 10am to 12 noon
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Child 1 Name *
Child 1 Age *
Child 2 Name
Child 2 Age
Child 3 Name
Child 3 Age
Parent/Guardian First Name *
Parent/Guardian Last Name *
Street Address *
City *
Zip Code *
Parent/Guardian Phone Number *
Parent/Guardian Email Address *
Please list any food allergies that your child/ren may have.  If they do not, please write none. *
Do you have a church home? *
If yes, to which church to you belong?
By entering my name below, I hereby give my consent as the parent/guardian of the above named child/ren to attend/participate in the Christmas for Kids program at Christ Lutheran Church at 13009 N Elderberry Ct, Lodi, CA 95242. My child/ren and I hereby release, indemnify, and hold harmless the church, its employees and/or volunteers from any and all liability from any claim, injury, or loss sustained by or during my child's participation during Christmas for Kids. *
I authorize Christ Lutheran Church to take and use photography and/or video of my child for crafts, keepsakes, or promotional purposes in any type of media and I understand I will not be compensated for any such use.   *
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