North Dakota District Lutheran Laymen's League

This is a generic registration form for North Dakota LLL Events.
You may submit your form electronically but we also recommend that you print it out and bring it in.

If you are under 18, this form MUST be signed at the bottom by a parent or legal guardian.
YOUR REGISTRATION IS NOT FINAL UNTIL YOU HAVE PAID THE DEPOSIT FOR THIS EVENT.

Event Date(s):
Full Name:
Address Line 1:
Address Line 2:
Birthdate:
Email:
Parent Names:
Parental Numbers:
Secondary Contact:
Secondary Numbers:
Insurance Company:
Ins. Phone Number:
Policy Number:
Allergies:
Medications:
Additional Info:
Enter 777 here:
Permission Signature of Parent/Guardian:

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