Register for High Voltage

Child's Information

Child's Name:

Gender: Male Female

Grade (Fall 08): 5th 6th

Birth Date:
Year: 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 Month: January February March April May June July August September October November December Date: 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Has this child been baptized? Yes No

Baptismal Date:
Year: 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 Month: January February March April May June July August September October November December Date: 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Has this child received first communion? Yes No

Food/Medication Allergies:

Does this child have any special needs (physical, emotional, or developmental)?
Yes No
If so, explain:

Contact Information

Parent/Guardian's Name:

Home Phone: ( ) -

Mailing Address:
Address Line 1:
Address Line 2:
City:
State:
Zip Code:

Email Address:

Parent/Guardian's Name:

Home Phone: ( ) -

Mailing Address:
Address Line 1:
Address Line 2:
City:
State:
Zip Code:

Email Address:

Participation Agreement

As a commitment to the baptismal promise I made to my child...
~ I will pray for my child throughout his/her faith journey.
~ I will come to High Voltage with my child a minimum of three times throughout the year as a helper in the classroom.
~ I will spend time with my child in God's Word.

Do You agree to the above statements? Yes No

Do you grant Holy Cross Lutheran Church use of pictures or videos of your child involved in educational and fellowhip activities planned by our church? These pictures could be displayed on our website (no names listed), in the church or as part of publications. A "yes" indicates your approval,"no" indicates we may not use them. Yes No

Questions/Comments: