Beruflich Dokumente
Kultur Dokumente
Personal Information
Name:_______________________________ Age:_____ Sex: M F (circle one)
Address:_________________________________City:__________________________
State:_____ Zip:_________________ Phone:__________________________________
Date of Birth:________________
Parent’s Information
Name:_______________________________Phone:_____________________________
Address:__________________________________ City:_____________ Zip:________
Health Information
Are you in excellent health?________ If no, why?_______________________________
_______________________________________________________________________
Do you take any medication?________ If yes, please list:_________________________
_______________________________________________________________________
**IMPORTANT NOTE: Cost of The Water Ski Party is $5. Make checks payable to
Lake Stevens AG and write “Water Ski Party” and attending student’s name in the “for”
column. Thanks! Questions? Contact Pastor Jeff at: Phone: 425.334.3700 E-mail:
Jeffandtiffgraham@yahoo.com