Glendale Lutheran Church - VBS Registration

Vacation Bible School
Family Registration Form
June 6-10, 2011
(9 a.m - Noon)

If you would like to register your child for Glendale's VBS, just fill out the form below and submit it using the button at the bottom of the page.

Note:
1. Please complete one per household
2. Age 3(potty-trained) - those entering 6th grade (fall 2011)
3. Suggested donation per child: $6 — covers t-shirt and the week-long program.
4. PAYMENT MUST ACCOMPANY REGISTRATION
If registering online, please send in or drop off payment within one week of submitting registration.
5. All children with paid registration by May 15 will receive a t-shirt.
6. Complimentary Music CDs are available for families registered by May 15.
7. Registrations received after May 15 will receive CDs and t-shirts based on availability.

Household Last Name:
E-mail Address:
Household Street Address:
City, State and Zip:
Home Phone:
Cell Phone:
Name of Parent or Guardian:
Emergency Contact:
Emergency Phone:
Brought to VBS By:
Yes, we have a church home No, we do not have a church home We would like information about Glendale Lutheran Church	Church name:

Please list ALL children who are registering for VBS:
*T-Shirt Child and Adult Sizes**	Child's Name	Birth Date	Grade in 2010-2011	Food Allergies or Medical Concerns**	Name of Child’s Friend (if applicable) ***

* Child's size: CXS (2-4), CS (6-8), CM (10-12), CL (14-16), CXL(18-20). Adult Sizes AS, AM, AL.
** If your child has special food needs, please send a snack each day labeled with your child’s name.
*** We will make every attempt to honor your request to place your child’s friend in their group. Registrations need to be in by May 15 to accommodate requests.

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