6-8th Grade Midweek Registration

Midweek Participant's Name *

First

Middle

Last

Male or Female *

Male
Female

Date of Birth *

MM/DD/YYYY

Grade in school *

6th
7th
8th

Name of Middle School Attending *

Baptized? *

Yes
No

Parent's Names *

Address *

Please enter your street address, city, state/region, postal/zip code and country.

Phone *

(###) - ### - ####

Parent's Email *

Current Home church *

Photo 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. *

Yes
No

Does your child/children have any food allergies, medical or behavioral issues that we should know about? If yes, please explain and specify which child. *

7th and 8th graders be expected to serve in church occasionally as usher, acolyte, or youth choir. Which areas of service would your child like to participate in? *

Usher
Acolyte
Youth Choir

For parents - The Board of Youth Ministry is looking for additional adults to help with events, driving youth to and from events, or chaperoning events. If you are willing to help please write your name and the best way that we can contact you.

As a parent would you be interested in serving as a small group leader in the program? *

Yes, please contact me!
No, I have other commitments.
I can help as a sub occasionally!

The Youth Ministry would like a cell phone number for a parent and/or a student to let you know about upcoming events! If you would like to be included in these notifications please include as many cell numbers as you would like.

Registration Fee

Payment Method *

Pay Now via PayPal
Pay Later via Check/Cash

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