BHCC VBS REGISTRATION
Child's Name *
Your answer
Grade Just Completed *
Age *
Your answer
Birthday *
MM
/
DD
/
YYYY
Parent's Name *
Your answer
Parents Phone *
Your answer
Parent's E-Mail
Your answer
Parents Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Emergency Contact During Week *
Your answer
Emergency Contact Cell Phone *
Your answer
Emergency Contact Home Phone
Your answer
Any Known Allergies (Snacks are provided each day. If your child has severe allergies, please provide their own snack.) *
Your answer
Does your child have their own Bible? *
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