VBS 2015 Registration
Email Address*
Child's Name(s)*
Parent/Guardian's Name(s)*
Address*
Home Phone Number*
Cell Phone Number*
Child's Age*
Current Grade (2015-2016 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)*
Do we have your permission to take your child's picture to use on our social media?*
Home Congregation (If Any)


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