VCS Registration Form 2015 - St Athanasius Orthodox Church

REGISTER NOW
PANAGIA PANTOVASILISSA
Parish Name
GREEK ORTHODOX CHURCH
Church
Parish
StreetCreek Road
3001 Tates
Parish City, State, Zip
Lexington, KY 40502
JUNE
1 at 8:45
Day,
Month
Dateam to 2:00 pm
to
Day,
Month
Date
JUNE
5
9:00
a.m. – noon
9:45 am
2:00 pm
Ages 3
5 – 11
14
Everyone welcome!
May 22 Date
Please register by Deadline
For more information, call
Mandy Xenos
Coordinator
Name
(859) 420-7492
(###)
###-####
CRAFTS
MUSIC
LESSONS
WORSHIP
ACTIVITIES
SNACKS
GAMES
DAILY ASSEMBLIES
VCS Registration Form ____
Parent’s Name
Phone #
Street Address
Cell/Emergency #
City, State, Zip
E-mail address
Caregiver’s Name
Caregiver’s Phone #
Child’s Name
Baptismal Name
Grade Next Fall
Age
Birth Date
Church/Parish Affiliation
Food allergies or other medical conditions we should be aware of
Yes, I would like to help with
Mail registration to
Please enclose $
© 2008 Barbara Harris, Laura Morton, and Rhonda Webb
The purchaser (or institution for which this program was purchased) is granted
permission to reproduce this page for its own use in presenting this program.
per child.
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