2019 Vacation Bible School
Please fill out one form per participant (both adults and children)
Monday, June 17 - Friday, June 21: 6:00 - 8:30 PM
Nokesville Church of the Brethren
Contact us at ((703) 594-2685, nokesvillecob@nokesvillecob.org
Participant's Name *
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Age (if under 18)
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Email *
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Emergency Contact Number *
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Emergency Contact Relationship *
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Food Allergies
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Other Allergies or medical conditions
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