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VBS 2015 Registration
Email Address
*
Child's Name(s)
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Parent/Guardian's Name(s)
*
Address
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Home Phone Number
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Cell Phone Number
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Child's Age
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Current Grade (2015-2016 School Year)
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Please List Any Allergies (Including Food Allergies)
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Emergency Contact's Name
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Emergency Contact's Phone
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Emergency Contact's Relationship to Child
*
Person Picking Up Your Child (Name and Phone)
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Do we have your permission to take your child's picture to use on our social media?
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Yes
No
Home Congregation (If Any)
Submit