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Vacation Bible School

July 8 - 12, 2019

5:45pm - 8:00pm

Child's Name *
Child's Name
Child's Gender *
Parent/Guardian Name *
Parent/Guardian Name
Address *
Address
Parent/Guardian Phone Number *
Parent/Guardian Phone Number
Child's Birth Date *
Child's Birth Date
Must have completed Kindergarten in May 2019 to register.
Child's Last Grade Completed *
Please list anything you child is allergic to
Emergency Contact *
Emergency Contact
Emergency Contact *
Emergency Contact
Emergency Contact
Emergency Contact
Emergency Contact
Emergency Contact
Do you attend a local church? *
May we have permission to photograph your child? *
May we have permission to use your child's photographs in church publications for the purpose of promotion? *