Register by checking the box next to following activities:
Helping Hands Camp
Grade
(Entering in fall 2008)
3-5
Date
June
24-26
Cost
$10
Code (Use this code
for paying online)
EHHC
Art Camp
Grade
(Entering in fall 2008)
1-6
Date
July
14-18
Cost
$15
Code (Use this code
for paying online)
EAC
Vacation Bible School
Grade
(Entering in fall 2008)
Ages 3 - Grade 6
Date
Aug.
4-7
Cost
Free
Code (Use this code
for paying online)
EVBS
FamServe Mission Trip
Grade
(Entering in fall 2008)
Family
Date
June
29-July 3
Cost
$250
2/People; $125 each additional
Code (Use this code
for paying online)
FMT
Lifest!*
Grade
(Entering in fall 2008)
Family
Date
July
10-13
Cost
*$40/Daily
*$84 Full
Code (Use this code
for paying online)
FLFD
FLFF
Family Art Nights
Grade
(Entering in fall 2008)
Family
Date
July
14-17
Cost
$25/family
Code (Use this code
for paying online)
FRT2
Family Camp Weekend
Grade
(Entering in fall 2008)
Family
Date
July
18-20
Cost
$220
2/People
$60 each
Code (Use this code
for paying online)
FRT2
My Dad & Me -
Baseball
Grade
(Entering in fall 2008)
Family
Date
Aug. 10
Cost
$18/person
Code (Use this code
for paying online)
FBB
Credit/Debit card (Go to "Online Payments" link on home page after you complete this form.)
Financial assistance is requested. No one will be denied participation due to financial hardship.
For scholarship information, contact Andy Moscinski at 920-733-2303.
Child No. 1 First Name
Child No. 1 Last Name
Child No. 1 Grade in fall 2008 (required)
Child No. 1 Phone
Child No. 1 E-mail
Child No. 2 First Name
Child No. 2 Last Name
Child No. 2 Grade in fall 2008 (required)
Child No. 2 Phone
Child No. 2 E-mail
Child No. 3 First Name
Child No. 3 Last Name
Child No. 3 Grade in fall 2008 (required)
Child No. 3 Phone
Child No. 3 E-mail
Child No. 4 First Name
Child No. 4 Last Name
Child No. 4 Grade in fall 2008 (required)
Child No. 4 Grade in fall 2008
Child No. 4 Phone
Child No. 4 E-mail
Register by checking the box next to following activities:
Adventure Camp
Grade
(Entering in fall 2008)
6-7
Date
June
9-12
Cost
$20
Code (Use this code
for paying online)
YAC
Road Trip 1:
Milwaukee
Grade
(Entering in fall 2008)
10-12+
Date
June 12-15
Cost
$130
Code (Use this code
for paying online)
YRT1
Noah's Ark
Grade
(Entering in fall 2008)
6-8
Date
June 13
Cost
$30
Code (Use this code
for paying online)
YNAM
Noah's Ark & Campout
Grade
(Entering in fall 2008)
9-12+
Date
June
19-20
Cost
$50
Code (Use this code
for paying online)
YNAH
Lifest!*
Grade
(Entering in fall 2008)
7-12+
Date
July
10-13
Cost
*$40/Daily
*$84 Full
Code (Use this code
for paying online)
YLFD
YLFF
Art Camp
Grade
(Entering in fall 2008)
7-12+
Date
July
14-18
Cost
$15
Code (Use this code
for paying online)
YART
Road Trip 11:
Minneapolis
Grade
(Entering in fall 2008)
10-12+
Date
July
17-20
Cost
$135
Code (Use this code
for paying online)
YRT2
Advanced Adventure Camp
Grade
(Entering in fall 2008)
8-9
Date
July 21-24
Cost
$45
Code (Use this code
for paying online)
YAAC
Boundary Waters
Grade
(Entering in fall 2008)
10-12+
Date
July 28-Aug. 1
Cost
$225
Code (Use this code
for paying online)
YBW
Credit/Debit card (Go to "Online Payments" link on home page after you complete this form.)
Financial assistance is requested. No one will be denied participation due to financial hardship.
For scholarship information, contact Andy Moscinski at 920-733-2303.
Child No. 1 First Name
Child No. 1 Last Name
Child No. 1 Grade in fall 2008
Child No. 1 Phone
Child No. 1 E-mail
Child No. 2 First Name
Child No. 2 Last Name
Child No. 2 Grade in fall 2008
Child No. 2 Phone
Child No. 2 E-mail
Child No. 3 First Name
Child No. 3 Last Name
Child No. 3 Grade in fall 2008
Child No. 3 Phone
Child No. 3 E-mail
Child No. 4 First Name
Child No. 4 Last Name
Child No. 4 Grade in fall 2008
Child No. 4 Phone
Child No. 4 E-mail
Parent (Guardian) First Name
Parent (Guardian) Last Name
E-mail
Emergency Contact
First Name
Emergency Contact
Last Name
Emergency Contact Primary phone and/or cell phone
Physician's First and Last Name
Physician's Phone
Insurance carrier
Insurance Policy #
Child No. 1
First Name
Child No. 1
Last Name
Allergies
List current medications
Date of last tetanus shot
List health problems
Child No.2
First Name
Child No.2
Last Name
Allergies
List current medications
Date of last tetanus shot
List health problems
Child No. 3
First Name
Child No. 3
Last Name
Allergies
List current medications
Date of last tetanus shot
List health problems
Child No. 4
First Name
Child No. 4
Last Name
Allergies
List current medications
Date of last tetanus shot
List health problems
I give permission to FELC staff age 21 and older to transport my child(ren) to and from activities.
Yes
No
FELC may use pictures of my child(ren) on its Web site and associated media and promotions.
Yes
No
Parent (guardian) signature
By entering my name in the field below, I am submitting my signature.
ATTENTION ELEMENTARY SCHOOL STUDENTS: This section is optional, to measure your interest. Please provide feedback!
I would like the summer staff to contact me about the following summer activities,
with the understanding that by checking a box,
I am not committed to the activity:
Club KIDSlife!
(Grades 1-6)
WayOut Wednesdays (Grades 1-6)
COW (Campfires on Wednesdays (after worship)
Worship Assistants (Family)
Please send me free weekly e-mail reminders about FELC youth activities:
E-mail address:
ATTENTION MIDDLE SCHOOL & HIGH SCHOOL STUDENTS: This section is optional, to measure your interest. Please provide feedback!
I would like the summer staff to contact me about the following summer activities,
with the understanding that by checking a box,
I am not committed to the activity:
Salvation
Army Meal Prep
Gal's or Guy's Study of Scripture
Volleyball & Campfires
Coffee & Conversations
Echoes Volunteer Work
Sunday Bowling
Lunch & Munch @ BWW
SLAM (Grades 7-9)
JAMS! (Grades 6-8)
Club 68 (Grades 6-8)
Worship in the Park Team
Wednesday Worship Team
VBS SIT (Staff in Training) (Gr. 8+)
I would like to participate in the following activities during Wednesday Night Worship:
Song leader/vocal
Special music
Soundboard
Instrument
Worship Assistant
Greeter/Usher
Crucifor
Children's Message
Sermon
Communion Setup/Cleanup
Drama
Other:
Please send me free weekly e-mail reminders about FELC youth activities:
E-mail address: