Kids' GROW Registration
Child's Registration Information:
Child's Last Name*
Child's First Name *
Child's Date of Birth (example: 01/25/2006)*
Child's School (so I can make sure they have someone they know in their group.)*
Child's Grade: *
 3 Yrs Old (& is toilette-trained)
 PreK 
 Kindergarten
 1st Grade
 2nd Grade
 3rd Grade
 4th Grade
 5th Grade
 6th, 7th, or 8th Grade
Children's Physical Restrictions/Medications/Allergies/Special Needs
Parent Information:
Mother's Last Name
Mother's First Name
Mother's Phone (Home & Cell)
Father's Last Name
Father's First Name
Father's Phone (Home & Cell)
Email Addresses (Please enter all email addresses you wish to use to receive announcements, updates, schedules, etc. Please enter them all on one line and separate them with a comma. Example: kidsgrow@immluth.org, churchoffice@immluth.org) *
Emergency Contact Information (Please enter information for a person who is not the mother or the father in case the parents cannot be reached.) *
Emergency Contact Name*
Phone Numbers: *
Relationship to Child*
I authorize Immanuel to use any photographs and video taken of my child for official church use, including the Immanuel website, Facebook, or pamphlets, without compensation.*
 YES
 NO
Kids' GROW is a ministry of Immanuel designed to help all children grow in faith and grow a stronger connection to Jesus through time in God's Word. As called workers at Immanuel, you have called us not only to serve but also to equip God's people for a role in the ministry. God has given EVERY BELIEVER spiritual gifts specifically for service in the church. I will be sending a volunteer survey/signup to you soon, please consider how you can participate this year as we work together to raise strong children with strong faith. *


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