Peace Lutheran Church

Evangelical Lutheran Church in America
(320) 685-7656

Little Lights Registration Form


Please complete/submit the information below for each child you would like to attend Little Lights. 


Name
Birthdate
Gender
Allergies
Parent/Guardian First & Last Name
Preferred Email Address
Alternate E-mail Address
Preferred Phone #
Alternate Phone #
Home Address (Street)
City/ST/Zip
Emergency Contact
Emergency Contact Relationship
Emergency Contact #
I authorize my child to be photographed (for marketing and communication purposes).yes
no
Please enter the letters that appear in this image
By clicking this box, I agree to enroll my child in Little Lights. I give permission for my child's personal information to be accessible to church staff and volunteers.