Children & Family Registration Form 2023-2024

This registration form is for children ages 3 through 6th grade for all of our children’s ministry activities. This includes Sunday mornings, Wednesday evenings, and all of our fellowship events. If you would like to register your child who is not yet 3, please use our nursery registration form.

We need a new form for each family every program year (July-June). If you have any questions, please contact Becky at children@hslckirkland.org.

Name of Adult Filling Out Form

First Name

Last Name

Primary Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Family Email Address

We will use this email address to communicate important CYF Ministries information.

Cell Phone

(###)

###

####

Would you like to receive text messages with last-minute reminders or cancellations (if necessary)

Yes

Additional Email Address for Communications

Optional

Member?

Yes

Student 1

Student 1 Name

First Name

Last Name

Student 1 Preferred Name

Student 1 Gender

Student 1 Birthdate

YYYY

Student 1 Baptism Date

YYYY

Student 1 Any Known Allergies (food, environment, etc.)

Student 1 Special Needs/Challenges Your Child Faces

Information is kept confidential.

Student 1 School

Student 1 Grade or Age

Student 1 has the following Bible

Student 2

Student 2 Name

First Name

Last Name

Student 2 Preferred Name

Student 2 Gender

Student 2 Birthdate

YYYY

Student 2 Baptism Date

YYYY

Student 2 Any Known Allergies (food environment, etc.)

Student 2 Special Needs/Challenges Your Child Faces

Information is kept confidential.

Student 2 School

Student 2 Grade or Age

Student 2 has the following Bible:

Student 3

Student 3 Name

First Name

Last Name

Student 3 Preferred Name

Student 3 Gender

Student 3 Birthdate

YYYY

Student 3 Baptism Date

YYYY

Student 3 Any Known Allergies (food environment, etc.)

Student 3 Special Needs/Challenges Your Child Faces

Information is kept confidential.

Student 3 School

Student 3 Grade or Age

Student 3 has the following Bible:

I would like my child(ren) to participate in the following activities. Please enter their names/initials in each box as applicable.

Sunday mornings (9:30 am)

Joyful Ringers Handbell Choir for grades 2-5 (Wednesdays at 5:15 pm)

Rejoicing Ringers Handbell Choir for grades 6 and older (Wednesdays at 5:45 pm)

Kidz Club (Wednesdays at 7:00 pm)

Fellowship events only (various)

Child's Cell Phone

By providing my child’s cell phone number, I give permission for HSLC to text my child with reminders about events or program updates.

(###)

###

####

Holy Spirit Lutheran Church is committed to keeping children safe. Consequently, we require all adults volunteering in ministries with children and youth to undergo background screening. Our guidelines are outlined in our Safe Haven Policy, available in our church office.

If I cannot be reached, I give permission for HSLC staff to call for medical assistance while my child(ren) are at HSLC.

Yes

I give my permission to Holy Spirit Lutheran church to use photographs and videos of my child(ren) in public displays, media releases and social media. I understand these photographs will not be sold or used for commercial purposes.

Yes

I verify that the above information is accurate.

Please write your name below.