LCM Summer FUNday School Registration 2009

10:15 - 11:10 a.m. Sundays,   June 7 - July 26, except July 5
Registration due by May 31.

To register, please fill out this form and click on the Submit button.
Questions, contact Diana Streckfuss or Donna Beal at 333-4444.

Student Information
Student NameBirthdateAgeSexGradeMember
of LCM		Baptized
M F Y N Y N
Medic Alert?   Y N     If yes, explain
Special Needs?   Y N     If yes, explain
M F Y N Y N
Medic Alert?   Y N     If yes, explain
Special Needs?   Y N     If yes, explain
M F Y N Y N
Medic Alert?   Y N     If yes, explain
Special Needs?   Y N     If yes, explain

Select Campus:   East   West
Parent/Guardian Information
Parent/Guardian Name(s)
Address:
City:     State:       Zip:  
Phone:     Cell Phone:  
E-mail Address:
Members of LCM?  Y N
Would you like information about becoming a member?  Y N

* We invite you to be a part of our ministry.  Please indicate area(s) of interest:
Teacher   Grade preferences?   1st Choice   2nd Choice   3rd Choice
Substitute Teacher Children & Family Ministry Team
Nursery Volunteer Special Programming
(Christmas program, VBS)
Administrative Helper Summer Leader/Assistant