Vbs Registration Form

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2016 VBS REGISTRATION FORM
June 20-24 from 9:00 a.m.-12:30 p.m.
Child’s Name ______________________________________
Parent/Guardian Name _______________________________
Address __________________________________________
______________________________________
E-mail Address
Phone Numbers: Home _________ Cell __________ Work __________
Age ______
Birthday ___________________________
School grade completed this school year _________________
Home Church ______________________________________
Allergies/Medical Information
_________________________________________________
_________________________________________________
_________________________________________________
Emergency Contacts
Name ________________________ Phone __________
Name ________________________ Phone __________

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