VBS Registration

VBS REGISTRATION

* Indicates required field

Child's Name *

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Last

Grade going into *

Child's Name *

First

Last

Grade going into *

Child's Name *

First

Last

Grade going into *

Address *

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Line 2

City

State

Zip Code

Country

Child's Name *

First

Last

Grade going into *

Child's Name *

First

Last

Grade going into *

Child's Name *

First

Last

Grade going into *

Medical Information (please include things such as food allergies) *

Parent/Guardian Name *

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Last

Phone Number Cell *

Email *

Phone Number Home *

Emergency Contact *

First

Last

Phone Number *

Emergency Contact *

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Last

Phone Number *

May we have permission to photograph your child? *

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May we have permission to use your child’s photograph for the purpose of promotion? *

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YOUR CART

VBS REGISTRATION

We'd Love to Have You Visit and Worship with Us! Service Time is 10:45am

Office Hours

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