2008 Children's Expo Registration Form

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                            ð    Friday, April 11                ð   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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