St. Mark’s Episcopal Church/VBS
August 2-6, 2010 9:30 a.m. - 12:00 p.m.
Registration Form

for children aged 3 – entering 5th grade in fall, 2010

Child’s Full Name

Age

(as of 8/1/10)

Grade/

Fall 2010

T-shirt Size* (see below)

Allergies/sensitivities

(include food)

Special needs/parent comments

1.

 

 

 

 

 

2.

 

 

 

 

 

3.

 

 

 

 

 

*Extra Small (4-6) Small (6-8), Medium (8-10), Large (10-12), XL (14-16)

A suggested registration fee of $20/child /$45 maximum family fee (scholarships available) for the week is appreciated to cover

program costs.  Please make checks payable to St. Mark’s Church with “VBS” in the memo space.

 

Parent/Guardian Name:                                                                                                  E-mail Address:

 

Home Address:                                                                  City/Town:

 

Home Phone:                                Cell Number:                           Work Number:

 

Emergency Contact Name/Number:

 

People to whom my child can be released:

 

I am available to assist during the week.  Days available:  M T W Th F

Area of interest: Grade/Age Children:          Circle all that apply:  Crafts     Snack     Recreation     Music     Drama     Storytelling

 

Register online by sending your form to childrensministry@stmarksglenellyn.org.
Donations may be dropped off at the church anytime.
Or, mail your form and check by JULY 19 to:
Vacation Bible School
St. Mark’s Episcopal Church
393 N. Main St.
Glen Ellyn, IL 60137