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Registracion del Participante

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Cross of Christ Ev. Lutheran Church & School

Location

9931 Foley Blvd.

Coon Rapids, MN 55433

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Contact Nicci Roper:

763-786-0637

nicciroper@crossofchrist.us

Primero, cuéntenos sobre usted:

Información de los Padres

Nombre

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Apellido

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Correo Electrónico

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Second Parent First Name

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Second Parent Last Name

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Dirección 1

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Dirección 2

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Ciudad

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Estado/Provincia

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ZIP/Código Postal

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Teléfono de Contacto 1

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Teléfono de Contacto 2

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Nombre del Contacto de Emergencia

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Relación del Contacto de Emergencia

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Teléfono del Contacto de Emergencia

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Nombre de recogida alternativo

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Teléfono de recogida alternativa

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Nombre alternativo de recogida 2

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Teléfono alternativo de recogida 2

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Afiliación de la iglesia local

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Cuéntanos sobre tu participante

Nombre

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Apellido

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Grado Entrando

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Género

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Fecha de nacimiento

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Alergias

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Preocupaciones Médicas

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I give the staff and volunteers at Cross of Christ permission to help my child in case of an emergency.

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Authorization for Release of Photographs

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¿Tienes amigos con los que te gustaría estar juntos? Haremos todo lo posible para juntar a los amigos seleccionados en el mismo grupo, pero no podemos prometer que todas las solicitudes serán posibles.

Amigo 1 Nombre

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Amigo 1 Apellido

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Amigo 2 Nombre

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Amigo 2 Apellido

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Comentarios

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