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Registration VBS 2019
Please fill out one form for each child
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* Indicates required question
Child's Name
*
Your answer
Parent or Guardian
*
Your answer
Phone number to best reach parent/guardian during VBS
*
Your answer
Address
*
Your answer
Email
Your answer
Grade Just Completed
*
Pre-k
Kindergarten
1st
2nd
3rd
4th
5th
Food Allergies (snacks will be served)
Peanut
Dairy
Gluten
Red Dye
I will be sending an alternative snack for my child
Other:
Other Allergies
Your answer
Emergency Contact Name and Number
*
Your answer
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