Whispering Pines Church VBS - Rome - Paul's Under Ground Church
Mon, July 8 - Fri, July 12
Email address *
First Name: *
(Student)
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Last Name: *
(Student)
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Date of Birth *
(MM/DD/YYYY)
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Age: *
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Grade going in to: *
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Parent/Guardian Name: *
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Street Address: *
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City: *
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State: *
(CA)
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Zip Code: *
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Home Phone: *
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Cell Phone: *
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Email: *
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Emergency Contact Name: *
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Emergency Contact Number: *
(555-555-5555)
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Allergies/Special Needs: *
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Special friend you child would like to be with:
We'll do our best to accomodate your request.
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How did you hear about Whispering Pines Church VBS?
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Please also complete a "Medical Release and Photo Consent" form at http://www.wpcog.com/wp-content/uploads/2017/05/VBS-Medical-Release-Form.pdf and bring to VBS with your child.
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