Faith Formation / JASS Registration

Date*
MM slash DD slash YYYY
Child Information
Child's Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Date of Baptism
MM slash DD slash YYYY
School*
Grade*
Age*
Child's Email
Home Phone*
Child's Mobile Phone
Parent Information
Parent's Name*
First Last
Parent's Email*
Parent's Mobile Phone*
Parent's Name
First Last
Parent's Email
Enter Email Confirm Email
Parent's Day / Work Phone
Parent's Mobile Phone
Address
Street Address Address Line 2 City State ZIP Code
Special
Does your child have any food allergy or sensitivity? If so, please list:
Does your child have any special needs that we need to know, for your child's experience to be as positive as possible?
Christian Education/Music
Christian Education
- GIFT: Growing in Faith Together (pre-K–grade 4)
- Confirmation (grades 5–8)
- Breakfast Club (grades 9–12)
Choirs
- Cherub Choir (Pre-K–grade 2)
- Choristers (grades 3–5)
- Cantabile (grades 6–12)
Instrumental/Handbells
- Recorders (grades 2–3)
- Chapel Ringers (grades 4–5)
- Chancel Handbells (grades 6–12)
- Augustana Instrumental Ensemble (all ages)
(Augustana Instrumental Ensemble meets periodically during the year to play with hymns and service music during worship.)
I play the following instrument(s):
The following additional people have permission to pick up my child:
Photo Release*
I give Augustana Lutheran Church permission to use Children and Family/Music Ministry photos of my child on Facebook and Augustana’s website and in Augustana’s livestream worship and publications as long as my child’s name is not publicized.
- I agree
- I do not agree
Signature*
Hover over the box and press, hold to sign. If on a mobile device, please use your finger.
Name
This field is for validation purposes and should be left unchanged.