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Childs Name *
Parent/ Guardian Name *
Physical Address *
Mailing Address *
Phone Number *
Childs Birthday     (m/d/yy) *
Last Grade Completed *
How will your Child ARRIVE at VBS? *
How will your child be PICKED UP from VBS? *
Who other than parent/guardian may pick child up? *
Do we have permission to Photograph your child? *
Is there any medical information or other important information we need to be aware of including food allergies *
Emergency Contacts (please list two) *
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