Hope Lutheran Church Youth Program Registration

Please complete the registration form below to register for KOK (Kids of the Kingdom) Sunday School for ages 4 up to 4th grade, H2H (Head to Heart) Confirmation for youth in grades 5-8, and High School Youth Group for grades 9-12. You only need to complete one registration form per family. Please contact the church office at 952-492-2099 or email office@hope-jordan.org with any questions.

Cost: Each program is $25 per student. The family maximum for programming is $60. There is no registration fee for High School Youth Group.

Payment Option 1: Pay online by going to our website at www.hope-jordan.org

1) Click "GIVE NOW" tab 2) Under "Outreach/Other" enter fee amount and designate which youth program(s) 3) Under "DONATION FREQUENCY" choose "ONE TIME" 4) Click "CONTINUE" button 5) Complete credit card payment information.

Payment Option 2: Checks can be made payable to Hope Lutheran Church. Please mail or drop off registration fees to Hope Lutheran Church, 201 Hope Ave., Jordan, MN 55352.

Parent/Guardian 1 Name *

Parent/Guardian 1 Cell Phone *

Parent/Guardian 1 Email *

Parent/Guardian 1 Mailing Address *

I would like to be contacted about volunteering in my child's program. *

Parent/Guardian 2 Name

Parent/Guardian 2 Cell Phone

Parent/Guardian 2 Email

Parent/Guardian 2 Mailing Address

I would like to be contacted about volunteering in my child's program.

I authorize emergency medical treatment for the below child(ren) provided that I cannot be reached. *

I give permission for the below child(ren) to be video/photographed for Hope Lutheran Church to use in their brochures, newsletters, worship presentation and media communication (i.e. Hope's website and facebook page). *

Off-site activities: I authorize my child to participate in any off-site youth activities. If I do not wish to have my child participate in an off-site activity, it will be my responsibility to keep my child home on the day of that activity. (CHOOSE NO for KOK and VBS. These programs do not participate in off-site activities.) *

We, the undersigned, agree to abide by the rules of Hope Lutheran Church. The students will respect the pastor, staff, volunteers, other students, as well as the building and property of our church. We understand that if there is misbehavior, there will be one verbal warning, a second offense will result in a phone call from the pastor or program coordinator to the parents. A third offense will require an in person conversation with the pastor &/or program coordinator. Parents may be asked to attend class with their child if behavior continues, or possibly teach their child at home. It is a privilege to participate in youth activities at Hope Lutheran church and everyone is expected to behave accordingly. *

Child 1

Child's name *

Date of Birth *

Age or Grade in September of the program year *

Gender

Allergies (Please explain and leave special instructions. Write N/A if this doesn't apply." *

Does your child have any academic or behavioral needs you would like to share? This information helps your child's leader support them so they have a positive and meaningful experience. This information is only shared with program coordinator and child's leader. (Write N/A if this doesn't apply.) *

Is there anything else you would like us to know about your child? (Write N/A if this doesn't apply.) *

Child 2

Child's name

Date of Birth

Age or Grade in September of the program year

Gender

Allergies (please explain and leave any special instructions)

Does your child have any academic or behavioral needs you would like to share? This information helps your child's leader support them so they have a positive and meaningful experience. This information is only shared with program coordinator and child's leader. (Write N/A if this doesn't apply.)

Is there anything else you would like us to know about your child? (Write N/A if this doesn't apply.)

Child 3

Child's name

Date of Birth

Age or Grade in September of the program year.

Gender

Allergies (please explain and leave any special instructions)

Does your child have any academic or behavioral needs you would like to share? This information helps your child's leader support them so they have a positive and meaningful experience. This information is only shared with program coordinator and child's leader. (Write N/A if this doesn't apply.)

Is there anything else you would like us to know about your child? (Write N/A if this doesn't apply.)

Child 4

Child's Name

Date of Birth

Age or Grade in September of the program year.

Gender

Allergies (please explain and leave any special instructions)

Does your child have any academic or behavioral needs you would like to share? This information helps your child's leader support them so they have a positive and meaningful experience. This information is only shared with program coordinator and child's leader. (Write N/A if this doesn't apply.)

Is there anything else you would like us to know about your child? (Write N/A if this doesn't apply.)