Oak Harbor Alliance Chapel - VBS Registration
Ages 4 thru 6th Grade (2018-2019 School Year)
One Form Per Child Please
Child's Name (First and Last) *
Your answer
Street Address *
Your answer
City, State, Zip Code *
Your answer
Home Phone *
Your answer
Home e-mail Address *
Your answer
Child's Age *
Child's Date of Birth (MM/DD/YEAR) *
Your answer
Child's Grade for 2018/2019 School Year *
In Case of Emergency, Contact (Name and Phone #) *
Your answer
First Parent/Guardian Name (First and Last) *
Your answer
First Parent/Guardian Cell Number *
Your answer
Second Parent/Guardian Name (First and Last)
Your answer
Second Parent/Guardian Cell Number
Your answer
Allergies or other medical conditions (if none, please type none) *
Your answer
Siblings attending VBS (Names and ages)
Your answer
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