SHBC 2018 VBS Registration Form
Child's Name: *
Your answer
Child's Complete Address: *
Your answer
Birth date: *
MM
/
DD
/
YYYY
Grade completed: *
Track (if completed 5th-7th grade):
Parent/Guardian name(s): *
Your answer
Parent/Guardian complete address: *
Your answer
Parent/Guardian phone number(s): *
Your answer
Emergency contact name and phone number: *
Your answer
My church home is:
Your answer
Allergies - please list: *
Your answer
Medical concerns - please list: *
Your answer
Email address (if you would like more information about future SHBC Kids' events):
Your answer
Submit
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