Rome VBS Child Registration
Providence Church VBS June 26-29, 2017

If you have questions about this form or VBS, please contact juliel@providencechurch.net.

Child's Name *
Your answer
Grade Entering *
Gender *
Address *
Your answer
Allergies/Special Conerns
Your answer
My child requires a buddy (helper) *
Required
I would like my child to be placed with this friend:
Your answer
May we use your child's photo(s) on our web site? *
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