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Heritage Lutheran Church Be Amazed!! August 6—10, 2007
9—11 AM For information, call 464-2810 or email heritagelc@verizon.net All children 3 years and older are invited. Registration Form (one per child please)
Child’s Name_______________________________________________ Grade Completed__________________ Age__________________ Parent’s Names_____________________________________________ Address_____________________________________________________ Home phone_____________________ Cell Phone__________________ Emergency Contact Person_____________________________________ Relationship to child____________________________________________ Emergency Contact phone______________________________________ Food Allergies Yes No List Allergies Medical Concerns Yes No Explain Church Membership at___________________________________________ Guest of_________________________________________________________
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