New Jerusalem Lutheran Church

New Jerusalem Lutheran Church (NJLC) is an ELCA congregation located in northern Loudoun County, Virginia in the town of Lovettsville.

Form: SODC registration online

Youth's Name

First Name

Last Name

Grade completed in 2015/Birthdate

Food allergies:

Parent/Guardian's Name

Address

City/State/Zip

Work/home phone

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Cell phone

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E-mail

Emergency contact

Emergency Contact Phone/Relationship to youth

Insurance company name/Guarantor

Insurance ID/Group number

Insurance phone number

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Special requests/considerations:

New Jerusalem Lutheran Church | 12942 Lutheran Church Road, Lovettsville, VA 20180, USA