REGISTER FOR VBS 2021
PLEASE COMPLETE 1 FORM PER CHILD
EMAIL *
CHILD'S NAME *
CHILD'S BIRTHDATE *
MM
/
DD
/
YYYY
LIST ALL FOOD ALLERGIES/ HEALTH CONCERNS *
LAST GRADE COMPLETED *
PARENT/GUARDIAN NAME(S) *
HOME ADDRESS *
CONTACT NUMBER *
ADDITIONAL CONTACT NUMBERS
WHO CAN PICK UP YOUR CHILD *
WHERE DO YOU ATTEND CHURCH *
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