Registration form for Sibshop

[Guest guest]

Here is the registration form for the Sibshop

Ellen

Registration Form

For ages 7-12

Child's Name: _______________________________ Parent's Name: _________________

Child's Age: ________ Address: _____________________________________________

Home Phone Number: ___________ Email: ______________________________________

Days Registering for:_________________________________________________________

Total Amount Enclosed: $_______________.

The cost of Sibshop is $20.00 Registration fees are non-refundable. Registration

is requested by

Please make checks or money orders payable to:

Tara Conley

937 E Division

Unit 1C

Lockport, IL 60441

Please take a moment to answer the following:

Has your child(ren) attended a Sibshop before? Yes _____No_________

If not, then additional forms will need to be completed.

I would like to request scholarship assistance. Yes _____No_________

Amount requested $_____

I would like to make a donation to help sponsor a Sibshop child. Yes

_____No_________

Donation amount $_____________enclosed

Please clip and save the information below for your use

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Regrets

If you cannot make Sibshop, please contact Tara at 708-989-3619 or

tara@... at least 2 days prior to the day.

Location: Friendship United Methodist Church 305 E. Boughton Rd. Bolingbrook, IL

60440

June 4th 2011 11-2pm

August 6th 2011 11-2pm

October 1st 2011 11-2pm

Registration 2011

When: Saturdays: June 4th, Aug 6th, Oct 1st

Time: 11am- 2pm (lunch will be served)

Who: Kids ages 7-12 who have a brother or sister with special needs

Cost: $20 per Sibshop

Where: Friendship United Methodist Church

305 E. Boughton Rd. Bolingbrook, IL 60440

Through group discussions, peer interactions and games, Sibs will get the

opportunity to:

a.. Talk about their brothers and sisters with others who really know what

it's like to have a sibling with a disability;

b.. Learn more about disabilities;

c.. Make new friends; and

d.. HAVE FUN!!!

Sibshop Facilitator: Tara Conley, MA, Sibling

Tara has been working with adults and children with disabilities for over 20

years. She has been a trained Sibshop facilitator since 1996. Her work is

inspired by her younger brother who has developmental disabilities.

Volunteers: Friendship United Methodist Youth Fellowship

Sponsored by Supporting Illinois Brothers and Sisters (www.sibsnetwork.org) and

Friendship United Methodist Church

Ellen Garber Bronfeld

egskb@...