Faith Connections & Youth Event Registration

We'd love to have your student (young children through high school) join us for Faith Connections and our Youth & Family Ministry events! If you have any questions about Faith Connections or Youth & Family Ministry, please contact Pastor Paige Evers (pr.paige@reformation-lutheran.net).

Parent Information
Parent/Guardian Name *
Parent/Guardian Name
Cell Phone *
Cell Phone
Home Phone *
Home Phone
Parent/Guardian Name 2
Parent/Guardian Name 2
Cell Phone
Cell Phone
Home Phone
Home Phone
Emergency Contact Information
Who can we contact in case of an emergency if you are not available?
Emergency Contact *
Emergency Contact
Emergency Contact Phone Number *
Emergency Contact Phone Number
Children Information
Child's Name
Child's Name
Birthdate
Birthdate
What grade is your child in?
Child's Name
Child's Name
Birthdate
Birthdate
What grade is your child in?
Child's Name
Child's Name
Birth Date
Birth Date
What grade is your child in?
Section 3
Legal Release
Photo Release *
Photographs and video may be taken and possibly used for publication in church bulletins, newsletters and website. As a parent/guardian, by selecting YES below, I give permission to Reformation Lutheran Church to photograph or videotape my child(ren) while attending Reformation Lutheran Church events
Medical Release *
As a parent/guardian, by selecting YES below, I authorize the treatment by qualified doctor of the minor(s) listed in the event of a medical emergency while attending events at Reformation Lutheran Church
Information Release *
By selecting YES below, I attest that I am the parent/guardian of above mentioned children and the information provided on this form is correct.