10658 210th Street West, Lakeville, MN 55044
Registration & Forms
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Registration and Forms
Student Permission Form
Trinity Evangelical Free Church – Lakeville, MN
Date of Birth
Special Learning/Physical Needs/Disabilities
Medications currently taking (include dosage)
If to be given at church must be brought in original container.
Parent / Guardian Information
Mom’s Cell Phone
Dad’s Cell Phone
Mom's Cell Phone Carrier
Dad's Cell Phone Carrier
Notify in case of emergency
Other than parent
Emergency contact phone number
Medical Insurance Carrier
Trinity Church reserves the right to use photos/videos from events on social media or in publications. If you prefer we don't use photos of your child, please contact Erin at firstname.lastname@example.org.
I grant permission for my son/daughter to receive transportation to and from Trinity Church for scheduled outings and events. I authorize the church to provide transportation and hold Trinity Church harmless from any liability due to mishaps occurring during scheduled outings and events.
I give my permission to any church staff or sponsor to administer first aid or to obtain the services of a licensed physician when emergency medical treatment is required. I understand that I will be notified as soon as possible, concerning any such emergency.
Parent / Guardian's Signature
This field is for validation purposes and should be left unchanged.
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