Highlands Upward Bound VBS 2017 Registration
Parent's (Guardian) Name
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Address
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Phone Number
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Email
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Child's Name/Age/Grade Just Completed
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Child 1 Tshirt size
Child's Name/Age/Grade Just Completed
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Child 2 Tshirt size
Child's Name/Age/Grade Just Completed
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Child 3 Tshirt size
Child's Name/Age/Grade Just Completed
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Child 4 Tshirt Size
Child's Name/Age/Grade Just Completed
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Child 5 Tshirt size
Child's Name/Age/Grade Just Completed
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Child 6 Tshirt size
Medical Release
In case I cannot be reached during and emergency, I give permission for my child to be treated by a licensed physician, and give permission for said physician to administer whatever care is necessary for their safety and care. I also further agree that I will not hold Highlands Presbyterian Church responsible for any expense incurred because of injury during Vacation Bible School.
Photography/Media Release
I grant Highlands Presbyterian Church permission to take photos of my child(ren) during Vacation Bible School and understand that those pictures may be used on social media or for promotional purposes. I understand that there will be no identifying information (names, ages, etc.) used along with pictures if they are used.
List Allergies or Medical Conditions
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