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VBS: Operation Restoration
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Name of Participant (First and Last)
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Date of Birth of Participant
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Grade Entering in the Fall
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Kindergarten (Or Have Completed One Year of Preschool)
1st
2nd
3rd
4th
5th
Please list any allergies (including food allergies) VBS Staff should be aware of:
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Parent/Guardian Information
Parent/Guardian Name
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Address (Including Zip Code)
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Phone Number
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Email Address
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In case of an emergency, contact person if parent/guardian cannot be reached:
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Phone Number of Emergency Contact
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