Please select those programs for which you are registering as a participant or volunteer, if yes above.
Phone of Participant
Date of Birth (Under 18 only)
Parent or Guardian #1
Parent or Guardian #1 Phone
Parent or Guardian Name #2
Parent or Guardian #2 Phone
By typing your name below, Holy Trinity Lutheran Church has permission to the following: *Use the participant's picture on the church web site or promotional materials. *Take the participant off site and transport them for furthering the ministry of Holy Trinity. *HTLC requires each parent/guardian of the minors to take responsibility that if the child does not comply with HTLC's guidelines on behavior (including bullying, lack of participation or respectful behavior), parents will be contacted to pick up the minor. *Transport a participant to a hospital for emergency medical treatment or surgery. I authorize alll medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and or paramedics for the participant and waive my right to informed consent of treatment. I release Holy Trinity Lutheran Church and individuals from liability in case of accident during activities related to Holy Trinity Lutheran Church as long as normal safety procedures have been taken.
Name of Adult if the above is under age 18