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2007-2008 STUDENT ENROLLMENT FORM

SUNDAY SCHOOL & ACTS

Bethany Lutheran Church, Overland Park Mission and Stilwell Mission
Complete one form for each child. Attention:  Peggy Thompson
  Date _____________________

Name_______________________________________ Birthdate:______  Class/Grade: _____________
                           Last                                    First  /  Middle
Goes by?____________________________________ Phone ________________________________

Address:____________________________________________________________________________
                                    Street                                                                                               City                                                Zip
Enroll in:
___ Sunday School ___ Overland Park Mission ___ Stilwell Mission
___ Midweek ACTS on Wednesday   ___ Overland Park Mission ___ Stilwell Mission

Level or Grade:
_____ Beginners (birthdate between 9/04-8/05) _____ Grade 3

_____ Preschool (birthdate between 9/03-8/04)

 _____ Grade 4
_____ Pre-Kindergarten (Kindergarten next year) _____ Grade 5
_____ Kindergarten _____ JAMmers (Stilwell) [PS-Grade 1]
_____ Grade 1 _____ Big DOGS (Stilwell) [Grades 2-5]
_____ Grade 2  

Family email address: ________________________________________________________________

               Name              Church Membership
Father:
 _________________________________
_________________________________
Mother:
 _________________________________
_________________________________

If student is NOT receiving Baptism Birthday cards, please provide baptism info:_________________
                                                                                                                                                                                                   Month / Day / Year
Known Allergies:____________________________________________________________________
Please note:  Snacks may be served in Sunday School/ACTS classes.  Children with SEVERE food allergies are asked to supply the teacher of the class with allergy information and to provide a safe snack weekly for their child.

Special medical needs?    Yes   /   No Special behavior/education needs?    Yes    /    No

If you have circled “Yes” to either of the above, please contact the Director of Child Ministry to communicate any specific information that would be helpful to the people serving your child.

Devotion materials sign up: [distributed through Sunday School classes]    (Please consider family subscriptions.)
______ Sign this Grade 1-5 student up to receive quarterly My Devotions.
______ Sign this Preschool-Kindergarten student up to receive monthly Happy Times.

Photo release for 2007-2008: (circle YES or NO)

YES, I grant permission for this student’s photograph to be used for any Bethany publication, news media usage, or on the World Wide Web.
NO, do not use my child’s photograph for any publication.

Parent Pledge:
 Having enrolled my child in this faith nurture program, I will:

______________________________________________________________________________________
Signature of Parent(s)