Email

Parent Name *

Parent Email *

Number of People

OneTwoThree

Child Name *

Child Email

Phone Number *

Street Address

City/State/Zip Code

Gender

Grade entering in Fall *

Date of Birth *

In Case of Emergency, contact name: *

Emergency Contact Phone: *

Guardian 1 Name: *

Guardian 1 Phone: *

Guardian 2 Name:

Guardian 2 Phone:

Allergies or Medical Conditions:

Special Education Needs:

Photo Release

I/we as parent/guardian of above named child(ren) give Grace Lutheran Church permission to use photographs and/or video of my child(ren) for ministry promotional purposes. I understand that promotional photographs and names of those pictured may be submitted to local newspapers or used on Grace Lutheran Church's Web site for publicity purposes.

Privacy Policy *

Waiver

Waiver By registering online and clicking here guardian agrees that they shall hold harmless Grace Lutheran Church, 1300 Kishwaukee Valley Road, Woodstock, Illinois and all its agents from any legal action or discourse that may arise from any and all accidents or injuries that may occur to the undersigned while engaging in athletic activities on the premises of Grace Lutheran Church for the period beginning July 2018.

privacy policy *