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GSUMC 2019 VBS Registration Form
Please complete a new form for EACH child participating
VBS will be held at GSUMC August 5-8, 2019 from 6:00-8:00 p.m.
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* Indicates required question
Child's Name
*
Your answer
Child's Gender
*
Choose
Male
Female
Child's Date of Birth
*
MM
/
DD
/
YYYY
Last School Grade Completed
*
Choose
Preschool
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Parent(s) Name
Your answer
Home Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Home Phone
*
Your answer
Parent/Caregiver's Cell Phone Number
*
Your answer
Parent/Caregiver's Email Address
Your answer
Home Church
Your answer
Please list any allergies or other medical conditions
Your answer
Name of Emergency Contact
*
Your answer
Phone Number of Emergency Contact
*
Your answer
Relationship to child
*
Your answer
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