Old Fields Baptist Church
VBS 2017 Registration Please Register Each Child Separately
Name
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Age / Grade Completed
Parent / Guardian Name
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Mailing Address
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City
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State
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Zip Code
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Physical Address (If Different from Mailing Address)
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Phone Number
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Emergency Contact Numbers
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Medical Information
List any medical information that we may need to know including allergies.
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Do you give Old Fields Baptist Church permission to photograph your child?
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