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VBS Registration
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Child's Name
Your answer
Parent/Guardian Name
Your answer
Address
Your answer
Phone Number
Your answer
Age
Your answer
Birthdate
Your answer
Last Grade Completed
Your answer
Medical Allergies
Your answer
Emergency Contacts
Your answer
Who may pick up your child at the end of each night?
Your answer
May we have permission to photograph your child?
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No
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May we have permission to use your child's photograph for promotional purposes, such as Facebook or our website?
Yes
No
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Does your child attend church anywhere?
Your answer
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