LOGOS PROGRAM ENROLLMENT
Name of Student Grade/Age Birthdate School Attending
Name(s) of Adults attending Bible study: _______________________________________________________
Address
Home Phone
Work/Cell Phone
Emergency Contact Person: Name Phone
Please list medical conditions we need to be aware of, and any allergies we need to consider: ____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
NOTE: CHECK HERE IF YOU NEED HELP
WITH TRANSPORTATION: _____
In case of medical emergency, the LOGOS
Program
personnel are authorized to take my child/youth
to the hospital for emergency
care.
Parent/Guardians Signature___________________________________________
IF YOU ARE NOT ALREADY COMMITTED TO
HELPING IN THE PROGRAM, PLEASE NOTE THE AREA YOU
ARE WILLING TO HELP:
Teacher's Aid
Advent Helper
Kitchen Crew
Hobbies/Crafts
Table Decorations
Table Parent
Transportation
Fall Festival Helper
Comforter