Christmas Fun Day Registration | Immanuel Lutheran Church and School

Parent Information

Name*

First Last

Email*

We will respect your email's privacy

Secondary Email (optional)

Home Phone

Cell Phone*

Work Phone

Address*

Street Address Address Line 2 City State ZIP / Postal Code

Your Family's Church Affiliation*

Child Informaton

Please enter the following information for EACH child that is being registered. If registering more than one child, please state that this is the case by answering "Yes" to the "Do you have anouther child to register" at the end of this form.

Are You A Member or Guest/Non-Member of Immanuel?*

Member
Non-Member / Guest

Child's Name*

First Last

My Relationship to this Minor Is*

Mother, Father, Legal Guardian, Aunt, Uncle, Grandparent, Etc.

Gender*

Male
Female

Current Age*

Birthday*

Grade*

Grade as of Fall 2023. Preschoolers are not eligible for enrollment. Note: If a Grade as of Fall 2023 is not listed, then the class is full. If you remain interested in enrolling your child into a full class, please email pastordonald@ilcp.org for possible options.

Any Known Allergies?*

No
Yes

List the Known Allergies*

Enter the known allergies, separated by commas

Another Child To Register?

If you answer "No" to the next question, you will be shown the fields needed complete your registration and make your payment. If you answer "Yes" then you will be returned to the top of the form so you can enroll the next child. Scroll down to the Child Information, as the Parental Information section will be automatically copied for you.

Do You Have Another Child To Register?*

Yes Please
No, I'm Done