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VBS Registration Form 2022
If you are interested in joining us for VBS at MUMC this year, please fill out this form!
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Email
*
Your email
Child's Full Name:
*
Your answer
Parent/Family/Guardian Full Name
*
Your answer
Address:
*
Your answer
Phone Number:
*
Your answer
Second Phone Number (Optional):
Your answer
Child's Date of Birth:
*
MM
/
DD
/
YYYY
Child's Age:
*
Your answer
Last school grade completed:
*
Your answer
Friends of your child at this church:
Your answer
Special needs/Allergies/Medical Information/Other (If none, say "none"):
*
Your answer
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