First Ev. Lutheran Church
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Register Your Child
1. Parent Information
2. Student Information
We found some errors when you submitted your information. Please see below and fill in the information needed.
Parent Personal Information
Parent First Name:
Parent Last Name:
Address 1:
Address 2:
City:
Country:
United States
Canada
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bangladesh
Belarus
Belgium
Belize
Bermuda
Bolivia
Bosnia and Herzegowina
Brazil
Bulgaria
Cayman Islands
Chile
China
Colombia
Costa Rica
Croatia (local Name: Hrvatska)
Cuba
Cyprus
Czech Republic
Denmark
Dominican Republic
Ecuador
Egypt
Finland
France
Georgia
Germany
Gibraltar
Greece
Guatemala
Honduras
Hong Kong
Hungary
India
Indonesia
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Korea, Democratic People's Republic of
Kuwait
Malaysia
Mexico
Netherlands
New Zealand
Norway
Pakistan
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Saudi Arabia
Singapore
Slovakia (Slovak Republic)
Slovenia
South Africa
Spain
Sweden
Switzerland
Taiwan
Thailand
Turkey
Ukraine
United Arab Emirates
United Kingdom
United States minor outlying islands
Uruguay
Uzbekistan
Venezuela
Yugoslavia
State:
AA (Armed Forces Americas)
AE (Armed Forces Europe)
Alabama
Alaska
American Samoa
AP (Armed Forces Pacific)
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip:
Email:
Re-Enter Email:
Home Phone Number:
(xxx-xxx-xxxx)
Cell Phone Number:
(xxx-xxx-xxxx)
Other Phone Number:
(xxx-xxx-xxxx)
Emergency Contact
Emergency Contact First Name:
Emergency Contact Last Name:
Emergency Phone 1:
(xxx-xxx-xxxx)
Emergency Phone 2:
(xxx-xxx-xxxx)
Alternate Pickup First Name:
Alternate Pickup Last Name:
Alternate Pickup Phone:
(xxx-xxx-xxxx)
Other Information
Home Church (If Applicable):