Ascension Lutheran Church - KS

2025-2026 Fusion Registration

Enter information for each child enrolling in Fusion

Student's Last Name

Student's First Name

Grade

School

Birthdate

Age

Baptism Date

Allergies

Other Special Needs

Contact Information

Dad's First Name

Dad's Last Name

Dad's Cell Number

Dad's Email

Dad's Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Preferred Contact Method

Phone call

Text

Email

Facebook Messenger

Mom's First Name

Mom's Last Name

Mom's Cell Number

Email

Mom's Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Preferred Contact Method

Phone call

Text

Email

Facebook Messenger

Emergency Contact Information

First Name

Last Name

Phone Number

Relationship

Contact Method

Phone Call

Text

Facebook Messenger

Other than parents, who is permitted to pick up your child following Fusion?

Name

Relationship

Phone Number

Photo Release

Photos are often taken at Fusion activities and events. They are used in Fusion highlights, Ascension newsletters, and possibly on the Ascension Facebook page or on the Ascension website. The Children's Christmas Service will be livestreamed. No child(ren) will be individually identified.

Do you grant permission for your child(ren) to be photographed in the listed activities?

Yes

No

Other Details

Does your child(ren) need transportation?

Yes

No

If yes, from/to what address?

Do you grant permission for your child(ren) to ride with a licensed, adult driver for activities such as delivering food to the Food Bank or visiting assisted living homes (notice will be given of any trip)?

Yes

No

Are you available to assist with special projects, programs, or other activities?

Yes

No

Activity and First Aid Consent

I understand that Fusion events at Ascension Lutheran Church, Pratt, Kansas, include snacks or meals, music, recreation, service activities, crafts, and Bible study time. I consent to the participation of my child(ren) in these events. I am aware that in addition to activities listed, the participant also may choose to participate in recreational games, sports activities, or projects that may involve additional risks, such as: jumping, running, or other physical movements, or using tools, scissors, or school supplies while taking part in the crafts or community service projects.

Ascension will provide basic first aid care, such as a Band-Aid for a minor cut or an ice pack for a bump. Parents/guardians will be immediately notified if any other accident or situation arises which needs medical attention.

I grant permission for my child(ren) to participate in Fusion activities at Ascension Lutheran Church.

2025-2026 Fusion Registration

Enter information for each child enrolling in Fusion

Contact Information

Emergency Contact Information

Photo Release

Other Details

Activity and First Aid Consent

About

Service Times

Contact Info

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