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Registracion del Participante

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River of LIFE Lutheran Church

Location

830 Sunrise Drive

Saint Peter, MN 56082

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Contact Dawn Eberhart:

507-327-3783

sundayschool@riveroflifelutheran.com

Primero, cuéntenos sobre usted:

Información de los Padres

PARENT/GUARDIAN #1

Nombre

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Apellido

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Teléfono de Contacto 1

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Teléfono de Contacto 2

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Correo Electrónico

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Dirección 1

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Ciudad

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Estado/Provincia

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ZIP/Código Postal

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How many family members are planning to attend the Free Meal?

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Afiliación de la iglesia local

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Indicate the areas you or your family member(s) are interested in participating in or would like more information about and we will follow up with you. (select all that apply in the drop down menu)

Multiple selections are allowed.

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Comentarios

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PARENT/GUARDIAN #2

Nombre

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Apellido

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Contact Phone

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Correo Electrónico

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Address (if different from above)

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Afiliación de la iglesia local

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Comentarios

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EMERGENCY CONTACT

in the event the Parent(s)/Guardian(s) listed above cannot be reached in a timely manner

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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By checking the box you will be emailed your Free Friends With God Kids Activity Pack.

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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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Medical Concerns, Conditions, Medications, or Special Needs

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Additional comments/info you would like us to be aware of

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MEDICAL TREATMENT PERMISSION: In the event of a medical emergency and when contact cannot be made in a timely manner to me and/or the emergency contact listed, I give my permission for my child to receive appropriate medical attention. In the event of an unforeseen emergency or any accidents, I release River of LIFE Lutheran Church, its employees and volunteers, and all those related to it, from any liability. I have provided emergency contact numbers and am assured that I will be contacted as soon as possible in the event that there is an emergency.

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LIABILITY RELEASE: To the fullest extent permitted by law, I release River of LIFE Lutheran Church, its trustees, officers, directors, employees, agents, and representatives from any injury, harm, damage, or death which may occur to my minor child while participating in the activity and agree to save and hold harmless River of LIFE Lutheran Church, its trustees, officers, directors, employees, agents, and representatives from any claims arising out of my minor child’s participation in the activity.

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PHOTOGRAPH RELEASE: I grant permission for River of LIFE Lutheran Church to post photos and videos of my child(ren) on its website, Facebook, slide show, or in other church publications.

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Do you have more than 1 child to register? It's Easy! If the Parent #1, Parent #2, & Emergency Contact sections remain the same* - click on the "Add Another Participant?" below & another Participant section will pop up. Do this as many times as you need to!

* IMPORTANT: if the Parent or Emergency Contact info differs for any child, you will want to click "Register!" and begin a new registration, as any changes made will apply to all children within that "family" registration.

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