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Whispering Pines Church Christmas VBS 2018
Saturday December 15th from 9:00am until noon
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First Name: *
(Student)
Last Name: *
(Student)
Date of Birth *
(MM/DD/YYYY)
Age: *
Grade going in to: *
Parent/Guardian Name: *
Street Address: *
City: *
State: *
(CA)
Zip Code: *
Home Phone: *
Cell Phone: *
Email: *
Emergency Contact Name: *
Emergency Contact Number: *
(555-555-5555)
Allergies/Special Needs: *
Special friend you child would like to be with:
We'll do our best to accomodate your request.
How did you hear about Whispering Pines Church VBS?
 Please also complete a "Medical Release and Photo Consent" form at http://www.wpcog.com/wp-content/uploads/2017/05/VBS-Medical-Release-Form.pdf and bring to VBS with your child.
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