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YEE HAW VBX REGISTRATION FORM
Yee Haw VBX Registration form
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* Indicates required question
Email
*
Your email
Child's Name
*
Your answer
Child's age
*
Your answer
Date of birth
*
MM
/
DD
/
YYYY
Last school grade completed
*
Your answer
Name of parent(s)
*
Your answer
Street address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Home telephone
Your answer
Parent/caregiver's cellphone
*
Your answer
Home church
Your answer
Allergies or other medical conditions
*
Your answer
In case of emergency contact
Your answer
Phone
*
Your answer
Relationship to child
*
Your answer
Photo consent for social media
*
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No
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