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Sign Up for VBS 2019 at St. Mark's UMC
Registration and Health Information
Email address *
Child's Name *
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Nick Name
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Gender
Home Street Address *
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City/State/Zip *
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Primary Phone Number *
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Second Phone Number *
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Work Phone
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Parent/Guardian Name and Email *
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Parent/Guardian Name and Email *
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Child's Birth Date *
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Child's Age *
Grade Level in 2019/20 School Year *
In case of an emergency during the dates of this event, please provide TWO parent/guardian names and phone numbers. *
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Please explain any food or other allergies which may limit activity, or information about your child that would be helpful to know: *
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A copy of your responses will be emailed to the address you provided.
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