Sunday School Online Registration Form

Family Information

Parent 1's Name: *

Parent 2's Name:

Home Address:

City/State:

Zip:

Home #:

Primary Cell #:

Secondary Cell #:

Email Address: *

Student

Child's First & Last Name: *

Date of Birth:

Age in years:

2011-12 School Grade:

Did your child attend Sunday School last year? YESNO

Baptized: YesNo Was your child Baptized?

Would you like information on your child being baptized at Peace Lutheran Church: Yes
No

Known Allergies/Medical Problems

To register more than one student, click the 'Add Student' on the right.

Add Student

Sunday School Assistance

Would you be willing to help out with Sunday School? Yes
Not at this time

PHOTO - VIDEO RELEASE

I give permission for my child’s photo, which may be taken during classes, to appear in The Peace Lutheran Church - Monthly Newsletter or on the Church's Website www.peaceplainfield.org. By checking here, I agree to the photo release, and terms as listed above. **checking will serve as your parental/guardian signature consent I agree

Additional Church Information

Would you like information on any of the following? Monthly Newsletter emailed to you
Children's Programs
Confirmation Program
The Core' - Sr. High youth group
Peaceful Hearts Preschool Please check all that apply.

Church Membership:

Are you a member of Peace Lutheran Church? YESNO

If not, may we contact you with information about our church and programs for your family? YES -Please call
Yes - Please email
NO -Please do not call

Please, review this form before registering. If you have any questions please contact the church office at (815) 436-9847 or email plc@peaceplainfield.org

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