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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)
Submit