Worship Education Youth Program Member Care Outreach
 
SUMMER CAMPS AT ST. LUKE’S CHURCH
Sign us up for VBS, June 23-26, 2008
      (3 yr olds – 5th graders)
      $35 per child; maximum of $90 per family

      Camp Allegro, July 7-11, 2008 (Registration closed)
      (K – 6th graders)     
     

Family and Emergency Contact Information: (« = required field)

Mother's Name:

  «
Father's Name:
Address:  «
City:  «
Primary Phone:   « xxx-xxx-xxxx
Secondary Phone:  xxx-xxx-xxxx
E-mail:
Are you a member of St. Luke's Church?  Yes       No   «

other church membership (if not St. Lukes)

Child No. 1
First Name:  «
Middle Initial:
Last Name:  «
Birth Date:  « mm/dd/yyyy
Age as of
June 1, 2008:		  «
School Grade going
into in Fall, 2008:		 (if applicable)
School Attending:
(if applicable)

Any Special Needs/Concerns (Medical or Other)?



If you are registering more than one child, continue below
or go to "Submit" button now.

 

Child No. 2
First Name: «
Middle Initial:
Last Name: «
Birth Date: « mm/dd/yyyy
Age as of
June 1, 2008:		 «
School Grade going
into in Fall, 2008:		 (if applicable)
School Attending:
(if applicable)

Any Special Needs/Concerns (Medical or Other)?

If you are registering more than 2 children,
please return to this form. Thank you.

PARENTS AND OLDER SIBLINGS: We could use your help in the following areas, please check any that you are willing and able to help with! Thank you!

YES, I would like to help out with VBS!
      (anyone 12-99 yrs old)

YES, I would like to help out with Camp Allegro!
      (12 years old and older)

YES, I would like to help out with BOTH

General comments/questions. Also, please provide name, e-mail address and phone of family members who would like to help out as a volunteer.

> > > >      < < < <

 

If you are registering more than 2 children,
please return to this form. Thank you.
 

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      St Luke's Home

205 North Prospect Avenue, Park Ridge, IL  60068    -    847/825-6659    -    fax:847/825-2557    -