Glendale Lutheran Church - VBS Registration

Vacation Bible School
Family Registration Form
June 7-11, 2010
(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 2010)
3. Suggested donation per child: $5.50 — covers t-shirt and the week-long program.
4. All children with paid registration by May 17 will receive a t-shirt.
5. Complimentary Music CDs are available for families registered by May 17.
6. Registrations received after May 17 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 17 to accommodate requests.

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