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Church Service Videos »  | COVID-19

St. John’s Lutheran Church

An ELCA Congregation in Northfield, Minnesota
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Registration Form

Registration 2019-2020

1 Parent/Guardians
2 Children
3 Medical
4 Children
5 Youth Ministry

  • Instructions

    Please use the following forms to register your child(ren) for the 2018-2019 school year. Visitors/new members are invited to register at any time throughout the year.

    Visit the Children page (Preschool to Grade 5) or Youth page (Grade 6 to 12) pages for more information on the programming.

    We appreciate your timely response in submitting this form. You only need to fill out this form once per family.

  • Parent/Guardian 1

  • Parent/Guardian 2

  • Basic & Contact Information

    Please provide basic information about each of your children.

  • Child 1

  • Child 2

  • Child 3

  • Child 4

  • Child 5

  • Medical & Emergency Information

    Please provide emergency contact information and medical information pertinent to each of your children.

  • Emergency Contact 1 (In the case a parent cannot be reached.)

  • Emergency Contact 2 (In the case a parent or Emergency Contact #1 cannot be reached.)

  • Medical Information

  • Insurance Information

    This is required by hospitals.

  • Parent/Guardian Consent

  • I am the parent or legal guardian of the child(ren) listed on this form, and I am informed of the activities offered by St. John’s Lutheran Church. As parent or legal guardian of my child(ren), I hereby consent for my child(ren) to attend and participate in all activities provided by St. John’s Lutheran Church.

    • I give permission for my child(ren) to participate fully in all activities sponsored by St. John’s Lutheran Church.
    • In case of emergency, I understand that every effort will be made to contact me. If I cannot be reached, I hereby give St. John’s permission to act in my behalf in seeking emergency treatment for my child(ren) in the event that such treatment is deemed necessary. I give permission to those administering emergency treatment to do so, using those measures deemed necessary. I understand that my insurance plan is the primary plan to pay for the dental, medical, or hospital care or treatment that is given to my child(ren).
    • I give my consent to all forms of transportation (personal vehicles, rented vehicles, commercial buses). John’s is not responsible for transportation by non-St. John’s people.
    • I give St. John’s permission to use my child(ren)’s picture for publicity. No personal information will be used.
  • By typing your name here this acts as your signature.

  • It is your responsibility to notify St. John‘s staff of any changes in information. (Policy changes, changes of health conditions, medications, address or phone changes.)

  • Programming for Pre-K Through Grade 5

    Please provide your programming preferences for each of your children age 2 through grade 5.

  • Child 1

  • Use their grade on September 1.
  • Age 2-3; Sunday morning, 9:50 – 10:30 a.m. Once per month.
  • Age 3 – Grade 5; Sunday Morning, 9:45 – 10:30 a.m.

  • Child 2

  • Use their grade on September 1.
  • Age 2-3; Sunday morning, 9:50 – 10:30 a.m. Once per month.
  • Age 3 – Grade 5; Sunday Morning, 9:45 – 10:30 a.m.

  • Child 3

  • Use their grade on September 1.
  • Age 2-3; Sunday morning, 9:50 – 10:30 a.m. Once per month.
  • Age 3 – Grade 5; Sunday Morning, 9:45 – 10:30 a.m.

  • Child 4

  • Use their grade on September 1.
  • Age 2-3; Sunday morning, 9:50 – 10:30 a.m. Once per month.
  • Age 3 – Grade 5; Sunday Morning, 9:45 – 10:30 a.m.

  • Child 5

  • Use their grade on September 1.
  • Age 3 – Grade 5; Sunday Morning, 9:45 – 10:30 a.m.
  • Age 2-3; Sunday morning, 9:50 – 10:30 a.m. Once per month.

  • Programming for Grades 6 Through 12

    Please provide your programming preferences for each of your children in grades 6 through 12.

  • Youth 1

  • Use their grade on September 1.
  • Please check the box next to the item(s) your youth would like to participate in.
  • Please check the box next to the item(s) your youth would like to help with.
  • Please write 3 names of requests for your Confirmation mentor. Adult mentors are members and the same gender.

  • Youth 2

  • Use their grade on September 1.
  • Please check the box next to the item(s) your youth would like to participate in.
  • Please check the box next to the item(s) your youth would like to help with.
  • Please write 3 names of requests for your Confirmation mentor. Adult mentors are members and the same gender.

  • Youth 3

  • Use their grade on September 1.
  • Please check the box next to the item(s) your youth would like to participate in.
  • Please check the box next to the item(s) your youth would like to help with.
  • Please write 3 names of requests for your Confirmation mentor. Adult mentors are members and the same gender.

  • Youth 4

  • Use their grade on September 1.
  • Please check the box next to the item(s) your youth would like to participate in.
  • Please check the box next to the item(s) your youth would like to help with.
  • Please write 3 names of requests for your Confirmation mentor. Adult mentors are members and the same gender.

  • Youth 5

  • Use their grade on September 1.
  • Please check the box next to the item(s) your youth would like to participate in.
  • Please check the box next to the item(s) your youth would like to help with.
  • Please write 3 names of requests for your Confirmation mentor. Adult mentors are members and the same gender.
  • This field is for validation purposes and should be left unchanged.
Outside photo of St. John’s
St. John’s Lutheran Church
500 Third Street West
Northfield, MN 55057
507-645-4429 office@stjohnsnorthfield.org

A Reconciling in Christ Reconciling in Christ logo congregation of the Evangelical Lutheran Church in America (ELCA).

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