Forms

Sunday School Registration Form

Fill out this form to register your preschool through grade 12 child(ren) for the 2017-2018 Sunday School Session. Use a separate form to register each child. Sunday School begins with Rally Day Activities at 9 a.m. Sun., Sept. 10, 2017.

If you prefer to do so, you may pick up a paper registration form from the table in the NW church building entry, fill it out and return it to the church office in person or by mail to P O Box 448, Cokato MN 55321. Building/office hours are 8 a.m. - 5 p.m. M-F.
  • First Name
    Last Name
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  • Medical/Allergy/Emergency Contact Information
  • Please give us any needed information about medical concerns or allergies that would affect your child. If your child has no special concerns, please type "NONE" in the box.
  • Please check one of the boxes below to let us know who we should call in case of emergency:
  • Give us the phone number of the person to contact in case of emergency if not a parent.
     
  • PARENT ONE INFORMATION
  • First Name
    Last Name
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  • PARENT TWO INFORMATION
  • First Name
    Last Name
  •  
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    /
  • Enter first and last name below:
    First Name
    Last Name
  • Enter first & last name below:
    First Name
    Last Name
  • Enter date of release and permission.
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    /
  • Check the appropriate box below. If you check the "yes" box please list in the box below for what condition.
  • If you checked the "yes" box please list for what condition. If you checked the "no" box please write "none" below.
  • Is the participant currently taking medications of any kind? Check the appropriate box below. If you check the "yes" box please list the medication and frequency of dose. If you checked the "no" box please enter "none" below.
  • List medication and frequency of dose or enter "none" below.
  • Has the participant had any significant past injuries, illnesses, or surgeries? Check appropriate box below. If you checked the "yes" box please list below what and when. If you checked the "no" box write "none" below.
  • List below any significant past injuries, illnesses or surgeries. If you checked the "no" box write "none" below.
  • Is the participant currently covered by medical insurance. Check the appropriate box below.
  • If you checked the "yes" box please list the name of the insurance provider:
  • List name of the primary insured and the policy or group number:
  • Please list name and phone number of physician.
    First Name
    Last Name
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    -
  • Fill in the First and Last Name to indicate agreement with this waiver.
    First Name
    Last Name
  • If needed, please list below any limits to medical treatment.