2019 VBS Registration Form
Please complete one form per family
Base your answers on child's age for next school year
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Home Address: *
City *
State *
Zip Code *
Phone Number *
Additional Phone Number
Additional Phone Number
Email (for VBS communication) *
Child one name *
Child one age *
List Allergies or state none *
List Medical Issues or state none *
Child two name
Child two age
Clear selection
List Allergies or state none
List Medical Issues or state none
Child three name
Child three age
Clear selection
List Medical Issues or state none
List Allergies or state none
Child four name
Child four age
Clear selection
List Allergies or state none
List Medical Issues or state none
Carpooling?  All parents will pick up their children at the end of each night via a car line (you will be notified of your pick-up location via email).  If you will be carpooling AT ANY TIME during the week of VBS, please indicate on the lines below, the names (first & last) of others who will be picking up your child from VBS.
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