Monthly Archives: July 2013

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VBS Registration

You’re invited to attend our Vacation Bible School!
when: JULY 22-26 | 6:30pm – 8:15pm
ages: PRE-K – 6TH GRADE

 

PERSONAL INFORMATION

Child's Name (required)

Child's Age (required)

Last School Grade Completed (required)

Address (required)

City (required)

State (required)

Postal Code (required)

Home Phone

Parent's Cell Phone

Who's Cell Phone is listed above?

 Dad Mom Grandpa Grandma Guardian

Parent's Email

Who's Email is Listed Above?

 Dad Mom Grandpa Grandma Guardian

Father's Name

Mother's Name

Name of the Church I Usually Attend

MEDICAL INFORMATION

Allergies and/or Medical Information

EMERGENCY CONTACT INFORMATION

Emergency Contact Name (required)

Emergency Contact Phone (required)

Emergency Contact Type (required)

 Father Mother Grandpa Grandma Aunt Uncle Other

If "other" please explain

ADDITIONAL INFORMATION

Additional Information We Might Find Useful

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