Children's Expo Registration Form

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2007

2008 Children's Expo Registration Form
Greater St. Louis Area Home Educators Children's Expo

PARENT INFORMATION

Name

Last:

First:

Address

 

City, State, Zip

 

Phone numbers

Home:

Cell:                           

Emergency:

Email

 

CHILD INFORMATION

Last name

 

First name

 

Age

 

Allergies or other information to note

 

Days attending                       

        Friday, April 11                   Saturday, April 12

MEDICAL RELEASE

I understand and agree to assume all of the risks, which may be encountered by my children listed above at the Greater St. Louis Area Home Educators (GSLAHE) Expo.  I do hereby agree to hold GSLAHE , First Evangelical Free Church, Teen Eagles and/or  their  volunteers harmless from any and all liability, actions, causes of actions, claims, expenses, and damages on account of injury to my child or property.  In the event that my child becomes injured or ill during any game or activity, I authorize GSLAHE and their representatives to secure first aid and/or services of a physician or hospital and agree to assume all financial obligations incurred therewith.

Signature of Parent

 

X_________________________________________________

To register, please

 print this page

(one form per child),

 fill out and mail with

total fee at right to:

 

GSLAHE

Children’s Expo

226 Victor Ct. 

Ballwin, MO  63021

2 days first child in family
$30.00
$__________
2 days additonal child in family
$25.00
$__________
1 day first child in family
$20.00
$__________
1 day additional child in family
$15.00
$__________
Lunch Friday April 11
$5.00 per child
$__________
Lunch, Saturday April 12th
$5.00 per child
$__________

Total  $ _______________

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