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Oak Harbor Alliance Chapel - VBS Registration
Ages 4 thru 6th Grade (2020-2021 School Year)
One Form Per Child Please
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Child's Name (First and Last)
*
Your answer
Street Address
*
Your answer
City, State, Zip Code
*
Your answer
Home Phone
*
Your answer
Home e-mail Address
*
Your answer
Child's Age
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4
5
6
7
8
9
10
11
Child's Date of Birth (MM/DD/YEAR)
*
Your answer
Child's Grade for 2020/2021 School Year
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Pre K
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
In Case of Emergency, Contact (Name and Phone #)
*
Your answer
Emergency Contact Relationship to Child
*
Your answer
Mother's Name (First and Last)
Your answer
Mother's Cell Number
Your answer
Father's Name (First and Last)
Your answer
Father's Cell Number
Your answer
Allergies or other medical conditions (if none, please type none)
*
Your answer
Siblings attending VBS (Names and ages)
Your answer
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