2022 VBS Registration (7/11/22 - 7/15/22) Theme

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2022 VBS Registration (7/11/22 - 7/15/22) Theme - MAKE WAVES!

Student (1) First Name *

Student (1) Last Name *

Birthdate *

YYYY

Grade (entering in the fall) *

Nursery available ONLY for parents helping out with the program.

Allergies/Emotional Needs *

None

Other:

Required

T-Shirt Size *

Student (2) First Name

Student (2) Last Name

Birthdate

YYYY

Grade (entering in the fall)

Nursery available ONLY for parents helping out with the program.

Allergies/Emotional Needs

None

Other:

T-Shirt Size

Student (3) First Name

Student (3) Last Name

Birthdate

YYYY

Grade (entering in the fall)

Nursery available ONLY for parents helping out with the program.

Allergies/Emotional Needs

None

Other:

T-Shirt Size

Street Address *

City, State, Zip *

Mom/Guardian Name (First & Last)

Mom/Guardian Cell

Mom/Guardian E-mail

Dad/Guardian Name (First & Last)

Dad/Guardian Cell

Dad/Guardian E-mail

Emergency Contact Name & Number *

Necessary should Mom/Dad/Guardian be unreachable during VBS. PLEASE PROVIDE A NAME (First & Last) & NUMBER NOT ALREADY GIVEN ABOVE.

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