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Farm Fresh Faith VBS Registration
Please complete this form to register your child for Farm Fresh Faith VBS at Bethany Baptist Church July 15th through July 19th.
Email address *
Student's Name *
Your answer
Gender *
Address *
Your answer
Date of birth *
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Age *
Your answer
Last school grade completed *
Your answer
Home church
Your answer
Parent/Guardian Name *
Your answer
Home phone # *
Your answer
Mom's cell #
Your answer
Dad's cell #
Your answer
Other phone #
Your answer
Allergies/Medical conditions *
Your answer
Emergency contact *
Your answer
Phone # *
Your answer
Relationship to child *
Your answer
Person other than parent authorized to pick up your child
Your answer
Permission to upload a photograph or video of your child to social media *
Parent/Guardian completing registration *
Your answer
Today's Date *
MM
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DD
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YYYY
A copy of your responses will be emailed to the address you provided.
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