Youth Christian Education Program - Student Registration Form

Pilgrim Evangelical Lutheran Church of the Unaltered Augsburg Confession
462 Meadowbrook Drive
West Bend, Wisconsin 53090
Student Registration Form - for Sunday School & Wednesday Catechism Classes
*Completion of this form is necessary to ensure we have up-to-date Emergency Contact Information and so that can prepare adequate class materials *

Parent or Guardian Information:
Parents' or Guardians' Names:*
Mailing Address: *
Email Address: *
Phone Number: *
Emergency Contact Number: *
Will you be attending the Adult Bible Study on Sunday mornings?
(You are strongly encouraged to attend, so that your children witness the importance of ongoing Christian education)*
 Yes
 No
If you will NOT be attending Adult Bible Study, where will you be in case we need you?
Worship service you normally attend? *
Student Information (enter each Student separately, as needed):

Student 1:
Student's Name:*
Date of Birth:*
Grade during the 2020-2021 Academic Year? (leave blank if none)
Food Allergies: (leave blank if none)
Any medical considerations of which we should be aware? (leave blank if none)


Student 2: (leave blank if none)
Student's Name:
Date of Birth:
Grade during the 2020-2021 Academic Year? (leave blank if none)
Food Allergies: (leave blank if none)
Any medical considerations of which we should be aware? (leave blank if none)


Student 3: (leave blank if none)
Student's Name:
Date of Birth:
Grade during the 2020-2021 Academic Year? (leave blank if none)
Food Allergies: (leave blank if none)
Any medical considerations of which we should be aware? (leave blank if none)
Please Note: Any youth who repeatedly disrupts Sunday School and/or Wednesday Catechism Classes with poor behavior will be required to have a parent or other adult guardian accompany them to all classes.


Submit