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VBS Registration
Please complete a form for each child attending
June 23-26 6-8pm
3916 Old William Penn Hwy
Murrysville, PA 15668
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Email
*
Your email
Child Name
*
Your answer
Grade Level
*
K-1 Grade
2-3 Grade
4-5 Grade
Special Needs/Allergies (if none, type N/A)
*
Your answer
Name(s) of Adult(s) Permitted to Pickup Child
*
Your answer
Phone Number
*
Your answer
Parent Name
*
Your answer
Comments and/or questions
Your answer
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