WOW 2011-2012

Name:		Attend:
		Women's Class Men's Class Divine Drama Faith Walk Class Doorway to Faith Class with Own Child Volunteer

		Women's Class Men's Class Divine Drama Faith Walk Class Doorway to Faith Class with Own Child Volunteer

Family Name
Address

City
State	Zip
Your Email Address
Home Phone
Cell Phone
Emergency Contact (other than parent)
Emergency Phone
Relationship to Child
Allergies?	No Yes If yes, list:
Medical Issues?	No Yes If yes, explain:
Home church (if not Faith Lutheran)
I give permission for photos/videos taken of my child(ren) during WOW to be used for Faith Lutheran Church public relations purposes.