3-5th Grade Midweek 2022/2023Fill out one form for each child participating in the Midweek Program.Please enable JavaScript in your browser to complete this form.How many children would you like to register? *1 Child - $ 10.002 Children - $ 20.003 Children - $ 30.00Child 1: Midweek Participant's Name *FirstMiddleLastChild 2: Midweek Participant's Name *FirstMiddleLastChild 3: Midweek Participant's Name *FirstMiddleLastChild 1: Male or Female *MaleFemaleChild 2: Male or Female *MaleFemaleChild 3: Male or Female *MaleFemaleChild 1: Date of BirthMM/DD/YYYYChild 2: Date of BirthMM/DD/YYYYChild 3: Date of BirthMM/DD/YYYYChild 1: Grade in school3rd4th5thChild 2: Grade in school3rd4th5thChild 3: Grade in school3rd4th5thChild 1: Name of Grade School AttendingChild 2: Name of Grade School AttendingChild 3: Name of Grade School AttendingChild 1: Baptized?YesNoChild 2: Baptized?YesNoChild 3: Baptized?YesNoParent's Names *Address *Please enter your street address, city, state/region, postal/zip code and country.Phone *(###) - ### - ####Parent's EmailCurrent Home churchChild 1: 3rd, 4th and 5th Graders are invited to serve in a worship service as the acolyte (candle lighter). Would your student like to serve as the acolyte?No, my child does not want to acolyte.Yes, please sign my child up for the 8:00 serviceYes, please sign my child up for the 9:30 serviceYes, please sign my child up for the 10:45 serviceChild 2: 3rd, 4th and 5th Graders are invited to serve in a worship service as the acolyte (candle lighter). Would your student like to serve as the acolyte?No, my child does not want to acolyte.Yes, please sign my child up for the 8:00 serviceYes, please sign my child up for the 9:30 serviceYes, please sign my child up for the 10:45 serviceChild 3: 3rd, 4th and 5th Graders are invited to serve in a worship service as the acolyte (candle lighter). Would your student like to serve as the acolyte?No, my child does not want to acolyte.Yes, please sign my child up for the 8:00 serviceYes, please sign my child up for the 9:30 serviceYes, please sign my child up for the 10:45 servicePhoto Release - I give my permission to Good Shepherd Lutheran Church to use photos of my child/children to be used in publications (website, bulletin, newsletter, etc) to promote events and news about Good Shepherd. No personal information such as address or phone number will be advertised or released.YesNoDoes your child/children have any food allergies, medical or behavioral issues that we should know about? If yes, please explain and specify which child.Would you be interested in helping as a small group leader?Yes, please contact me!No, I have other responsibilities that don't allow me to volunteer at this time.I can help as a sub occasionally!Payment Method *Pay Now via PayPalPay Later via CheckSubmit
