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2021 VBS Registration Wyatt Park Christian Church
Preschool-3rd grade VBS and 4th-6th grade Jr Missions
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Student's Name
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Date of Birth
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Age
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School last attended
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Grade last completed 2020-2021
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Preschool
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
Parent/Guardians name (s)
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Address
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Primary Phone number
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Emergency Contact
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Phone number of emergency Contact
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known Allergies or medical concerns
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I give permission for my child to be photographed with images potentially used on our Facebook page.
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