Home - St. Paul Greek Orthodox Church

St. Paul Greek Orthodox Church
Serving Southern Suburbs of Cleveland OH since 1966

Vacation Church School 2010
Save the Date

June 28 - July 2

More information will follow

VCS Registration Form

I would like to register for Vacation Church School as a:
	Student ($10 after June 7 -- please submit below)
	GOYA
	Volunteer
Name
Address
City State ZIP
Phone
E-mail
Age
Grade child will enter this Fall
Please indicate T-shirt size
	Youth Small (6-8)
	Youth Medium (10-12)
	Youth Large (14-16)
	Adult Small (34-36)
	Adult Medium (38-40)
	Adult Large (42-44)
	Adult X-Large (46-48)

In the event reasonable attempts to contact me at (phone no.)
or (Cell No.)
Or to contact (Other parent or guardian)
at (Phone No.)
or (Cell No.)
have been unsuccesful, I give my consent for: 1) The administration of any treatment deemed necessary by:
Dr. (Preferred physician)
at (Phone No.)
or Dr. (Preferred dentist)
at (Phone No.)
or in the event the designated preferred practitioner is not available, by another licensed physician or dentist and the transfer of the child to (hospital) or any hospital reasonable accessible.:
Facts concerning the child's medical history, including medicine and food allergies, medications being taken, and any physical impairments to which a physician should be alerted: