Children's Ministries Registration Form 2017-2018



What Activities will your child/family participate in?  Check all that apply at each site.
 Littlest Lutherans (Parent and children under the age of 3)WEtogether Education (ages 3 and up-High school)Family Night (once a month, alternates sites)Kids Connect (ages K-5th Grade)Confirmation (7th/8th grade alternating Wed.)High School Night
Tempe Site
What Activities will your child//family participate in?  Check all that apply at each site.
 Littlest Lutherans (Parent and children under the age of 3)WEtogether Education (ages 3 and up-High School)Joyful Noises (Parent/tot)Family Night (once a month, alternates sites)Jr. High Night (6th/7th/8th 2 wed. a month)
Gilbert Site
We love having families in worship...now we want you to be a PART of worship. Families and children are invited and encouraged to serve as ushers, greeters, lectors, and prayer and song leaders. Check what areas your family (or an individual in your family) is interested in and we will get back with you! Questions? Contact Tempe: Jaque Jecker jjecker@desertcross.org or Gilbert: Pastor Matt mdobyns@desertcross.org
 GreeterUsherLectorPrayer or Litany LeaderSong Leader
Tempe and Gilbert


I agree to the use of images of my children, including reproduction of photos, video, or audio by Desert Cross for promotion purposes. 
By checking Yes, you are agreeing to the terms listed above.  Checking Yes acts as your electronic signature. *
 

Emergency Contact Information

Please fill out every blank, if you need to type: NONE. *
 Alternate Contact #1Alternate Contact #2
Relation to Youth
Name
Phone Number

Health Information



I hereby release Desert Cross Lutheran Church, its staff and sponsors from responsibility and liabililty for any illness or injury that the above named child may sustain during any activity.  In the event of an emergency, I hereby authorize an adult leader of the activity, as agent for me, to consent to any X-ray examination, medical, dental, anesthetic, or surgical diagnosis, treatment, and hospital care advised and supervised by a licensed physician, surgeon, or dentist (as appropriate) licensed to practice under the laws of the state where the services are to be rendered, either at the physician's office or in the hospital.  I understand the activity director will endeavor to reach us should the nature of the injury or illness warrant it.  However, we will not hold any of the activity personnel responsible if efforts to contact me (us) are unseccessful.

*The information provided will be reviewed by the Parish Nurse and shared with adults having contact with this child.  Please call the church at 480.730.8600 if you have questions. 
By checking Yes, you are agreeing to the terms listed above.  Checking Yes acts as your electronic signature. *