Child's Name *

First Name

Last Name

Child's Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birth Date *

MM

DD

YYYY

Baptismal Date (if known)

MM

DD

YYYY

Home Phone *

(###)

###

####

Mom Cell

(###)

###

####

Dad Phone

(###)

###

####

Child Phone

(###)

###

####

Permissions *

My child has permission to participate in youth activities with Lutheran Church of Hope during the 2023-24 school year.

My child DOES NOT have permission to participate in youth activities with Lutheran Church of Hope.

I give permission for my child's photo to be taken. My child will not be identified by name. The photos may be used in church literature and displays, as well as on the website.

I DO NOT want my child's photo taken.