Road Map Registration Packet Fill out the sections that pertain to your family and submit to the church office by May 21. A timely response is one of the easiest and most effective ways that you can support the Children’s Ministries of Bethel Lutheran Church! If your children WILL NOT be participating in any on site programming during the 2017-18 school year, you do not need to return the registration packet but PLEASE contact the church office and let us know that you will not be participating. Please submit this form to the church office by May 21, 2017. Thank you! New members and visitors after May of 2017 are welcome to join us any time during the year and are asked to return this packet prior to their child’s participation in our ministries. Step 1 of 3 33% Last Name*Parent/Guardian Consent 2017-2018 am the parent or legal guardian of the child(ren) listed below, and I am informed of the activities offered by Bethel Lutheran Church located at 1321 North Avenue in the city of Northfield, County of Rice, and State of Minnesota, beginning on the day of August 1, 2017 and ending on the day of July 31, 2018. As parent or legal guardian of my child(ren), I hereby consent for my child(ren) to attend and participate in all on site activities provided by Bethel Lutheran Church.Parent/Guardian Consent (Print Name)Parent/Guardian Consent to Medical, Dental, or Hospital CareI am the parent or legal guardian of the below named child(ren). I con-sent to any x-ray examination, anesthetic, medical, or surgical diagnosis or treatment and hospital care under the general or special supervision and upon the advice of or to be rendered by a physician and surgeon li-censed under the Medical Practice Act for my child. This authority also extends to any x-ray examination, anes-thetic, dental, or surgical diagnosis or treatment and hospital care by a dentist licensed under the Dental Prac-tice Act for my child. I further agree to pay all charges for the dental, medical, or hospital care or treatment. As parent or legal guardian of my child(ren), I am responsible for the health care decisions of my child(ren) and am authorized to consent to the services to be rendered. I represent that my consent to and agreement to pay for the dental, medical, or hospital care or treatment to be rendered to my child(ren) is legally sufficient and that no consent from any other person is required by law.Parent Medical Consent (Print Name)Date Child(ren)'s Medical InformationName First Birthdate Allergies/Medications & Activity ExclusionsAdditional ChildrenYesNoName First Birthdate Allergies/Medications & Activity Exclusions Child InformationChildren – Please list all children born after September 1, 2006 and before September 1, 2014Last NameChildren's InformationFor each child enter First Name, Preferred Name, Birthdate & Grade in 2017/2018.Parent & Guardian InformationFather's Name First Last Address Street Address City State / Province / Region ZIP / Postal Code PhoneEmail Mother's Name First Last Mother's Address is the Same?YesNoAddress Street Address City State / Province / Region ZIP / Postal Code Mother's PhoneMother's Email Additional InformationFriend or Requested Teacher NameIf you would like your child in a Sunday School class with a particular teacher or friend, please indicate that here. Requests will be honored as we are ablePhotography Release Please do NOT include pictures of my child on the Bethel website and Facebook page It is ok to post my child's picture *Occasionally we will post pictures on our website and Facebook page of activities and events that take place at Bethel. If you do not check the above line, we will assume that we have your permission to post a picture with your child in it. We will never attach names to any photo to identify participants.Parent Contact for BAMIf you have children who will attend BAM, please indicate where you can be reached between 3:30 and 5:45 each Wednesday:MotherFatherGuardianBAM Absences Please let us know by NOON on the day you child will be absent. It is vital that you let us know if your child will not be attending BAM on a specific date. Unless we hear from you we assume that your child will be in attendance and we will begin to search for her/him if they do not arrive on the bus. Our first call will be the school to make sure the child was in attendance that day. Our next calls will be your cell phone, work phone, and home phones. It is very helpful if you can let us know no later than noon on the day they will be absent so that we can let the bus shepherds know that they will not be riding the bus that day. Thank you for your cooperation with this very important step in keeping your child safe.When will you pick up your child(ren) from BAM?Please note that there are no other activities scheduled during our choir rehearsals. See the BAM Schedule on page 6 of the Children’s Ministry Road Map. If your child is not planning to sing in one of our choirs or if they will not be staying for the entire afternoon for any other reason, please indicate at which time you will be picking them up:Picking Up Time:4:154:455:155:45*Please pick your child up at one of these scheduled times as it is distracting to our leaders and participants when students are pulled out of an activity already in session. Thank you!