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Vacation Bible School Registration
July 19-23
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Child's Name (First and Last)
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Your answer
Child's Date of Birth
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DD
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Parent/Guardian Names (First and Last)
*
Your answer
Phone Number Best to Reach You
*
Your answer
Last Grade Completed in School
*
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Does your child have any current medical conditions, allergies, or medications?
Your answer
May we have permission to use your child's photograph in publication? (No names are attached to any photos)
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Child's Name (First and Last)
*
Your answer
Child's Date of Birth
*
MM
/
DD
/
YYYY
Parent/Guardian Names (First and Last)
*
Your answer
Phone Number Best to Reach You
*
Your answer
Last Grade Completed in School
*
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Does your child have any current medical conditions, allergies, or medications?
Your answer
May we have permission to use your child's photograph in publication? (No names are attached to any photos)
Yes
No
Clear selection
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