VBS 2014 Registration
Email Address*
Child's Name*
Parent/Guardian's Name*
Address*
Home Phone Number*
Cell Phone Number
Child's Age*
Current Grade (2014-15 school year)*
Please List Any Allergies (including food allergies)*
Emergency Contact's Name*
Emergency Contact's Phone*
Emergency Contact's Relationship to Child*
Person Picking Up Your Child - Name and Phone*
Home Congregation (if any)


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