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Kid’s Bible Study

Posted on Mar 29, 2014

Medical/Information Sheet

Full name of youth *We need one form for each child that will attend, Each form is good for the entire year.
Birth Date *
Function
Parent's names *
Today's date *
Person dropping off child If other than parents
If not parent, relationship to child
Emergency contact number *
Your email address
Parent/guardian Home number *
home address
Second emergency number *In case we can't get a hold of you we need another phone number
information
Any allergies or any conditions we need to be aware of?

Verification

Please enter any two digits *Example: 12
This box is for spam protection - please leave it blank:

KBS meetings are held every other Friday, contact the church office
for a schedule at 530 622-3022

Sunday Morning Worship Times

Summer worship hours:
9:oo am Adult Bible Study
Sunday School

Worship: 10:00 am
with Holy Communion

Contact Info:

Address:
1200 Pinecrest Ct.
Placerville, CA 95667

Phone:
530.622.3022

Email:
firstlutheran@sbcglobal.net

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