VBS 2009
Creation
Celebration
Online
Registration

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Registrant Name

Address

City

State

Zip

Registrant Information

Phone (if registrant has one)

Email (if registrant has one)

Age

Date of Birth

School

School Grade Just Completed

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Parent / Guardian Name

Address

City

State

Zip

Parent / Guardian Information

Phone

Email

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Please make sure you fill in all of the fields that are applicable to your registration. Fields marked with a red asterisk * must be filled in. When you are completed filling out the form, click on the "Submit VBS Registration" button located on the bottom of the page.

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Emergency Contact Name

Relationship to Registrant

Emergency Contact Information

Phone

Email

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T-Shirt Size

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Number of Extra Siblings that you are Registering

Names, Birthdays and T-Shirt Sizes of Additional Registrants

Fees

The fee for the 2009 Creation Celebration Vacation Bible School is:
- $75.00 for a St. Mark congregation member
- $85.00 for a non-member

If you are registering more than one child, the fee for the extra registrations will be:
- $70.00 per extra child registered as a St. Mark congregation member
- $80.00 per extra child registered as a non-member

For example, say you are a St. Mark member and you are registering 2 children. Your total fee would be $145.00 ($75.00 for the first child and $70.00 for the second child.

Please send payment no later than July 15, 2009. Registration is limited on a first-come basis. Payment can be dropped of at the Church office or mailed to: St. Mark Lutheran Church • 1120 Curlew Road • Dunedin, FL 34698

If you have any questions, please don't hesitate to contact Maryanne Kehlenbach at 727-733-0474

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