Vacation Bible Camp Registration 2010
First Lutheran Church 403-242-4544
___July 19-23 OR ___Aug 23-27(please check one) Mon-Fri 9:30-12:30
Camp fee: $60 per child Ages: 4yr to Grade 4

Parent’s Names: __________________________________
Home Phone #: ________________
Email:
Address:  ______ ____________________________
Postal Code ______________

Children registered at least 7 days in advance will receive a t-shirt

Child’s Name:       

Grade entering: ______ Age: _____  Date of Birth:

Allergies/Medical/Learning Concerns:_______________
Tshirt Size: 2/4 (xs)_____ 6/8 (sm)_____ 10/12 (m)______ 14/16 (lg)______

Child’s Name:       

Grade entering: ______ Age: _____  Date of Birth:

Allergies/Medical/Learning Concerns:_______________

Tshirt Size: 2/4 (xs)_____ 6/8 (sm)_____ 10/12 (m)______ 14/16 (lg)______

Child’s Name:       
Grade entering: ______ Age: _____  Date of Birth:

Allergies/Medical/Learning Concerns:_______________

Tshirt Size: 2/4 (xs)_____ 6/8 (sm)_____ 10/12 (m)______ 14/16 (lg)______

Emergency Name and Phone Number during camp:

_______________________________________________

Pick up or Drop off person other than Parent:

_______________________________________________

I am interested in volunteering during camp:

Name:

Office Use Only (taxable receipt given for designated donation )
Registration Fee        ÿ $25 per child: x_____# of children	Total:
Suggested Donation  ÿ $35 per child: x_____# of children	Total:
Payment Method       Cash:      Chequ:      C.Card:             Paid:	Staff Initial:

Your email address will not be shared with anyone.  It will be used solely for the purposes of communicating regarding
Children and Family opportunities at First Lutheran Church.