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VBS Registration 2019
First United Methodist Church of Homosassa
Child's Age *
Date of Birth *
MM
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DD
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Grade *
Child's Name *
Your answer
Parent(s) Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
ZIP *
Your answer
Primary Telephone *
Your answer
Parent/Caregiver's Cell Phone *
Your answer
Home Email Address
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Home Church
Your answer
Child T-Shirt Size *
Allergies or other medical conditions
Your answer
What are your child's strengths? (Drawing, writing, encouraging, reading, attitude, social relationships, etc)
Your answer
What are some areas your child struggles with or needs your child has in this environment ( allergies, medical needs, struggles in reading, writing, relating to others, sensory differences, focus and attention...)
Your answer
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