Choir Chime & Hand Bell Summer Program

Monday-Friday 9:00 - 12:00 (noon)

August 22-26, 2005








City: Zip:


Phone Number:


Grade Level (completed by 6/05):

o 1st o 2nd o 3rd o 4th o 5th o 6th o 7th o 8th o 9th o10th o 11th o 12th o Adult


T-shirt Size:

Youth: o M; o L;

Adult: o S; o M; o L; o XL; o XXL o Other:


Music Experience (if any):


Existing Medical and / or Dietary Restrictions we should know about:



For Minors: Registration must be signed by a Parent and / or Guardian:


Name Signature Phone


$10.00 Registration Fee payable to: Island Presbyterian Church


Mail Registration to:

Attn: Girl Scout Troop #1023

1822 Huth Road

Grand Island, NY 14072


Registration Open: June 1 August 5, 2005