First Lutheran Church: Senior High

On-Line Trip Registration Form

To sign up, please fill in the following information. You will also need to download and fill out a Medical Form.

Trip/Event:
Participant's Name:
Parent's Name:

Participant's Email:
Parent's Email:

Participant's Phone/Cell:
Parent's Phone/Cell:
Home Phone:

Address:
City:
State: zip:

Date of Birth:

Home Church:

Gender:

Grade Just Completed:

T Shirt Size:

Parents are you interested in helping?:
Comments:

Arrangements: (You are not registered for the trip until your payment is received. FLC believes that finances should not prevent participation, so Camperships are available. Please indicate your need for a campership in the box to the right..)

Special Needs: (If your child has a special need it's very important for us to know so we can ensure your child has the best possible experience with VBS. Some examples of Special Needs are: ADD/ADHD, physical disabilities, Autism, Allergies, etc. Please let us know how we can help your child.)

FLC Mission Statement: Our mission at First Lutheran Church is to bring people
into a relationship with Jesus Christ, and to help them grow in the Christian Faith.