Vacation Bible School 2019
June 3rd-7th- 8:30am-12:00pm
Child's Name`
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Parent/ Guardian Name
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Address
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Home phone #
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Cell phone #
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Email
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Child's Birth Date (Including Year)
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Last grade complete in school
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gender
Medical (List any Allergies or Information we need to know about)
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Emergency Contact's Name
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Emergency Contact's Phone #
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Who may pick up your child?
Is your family active in a church?
May we have permission to photograph your child and use it for the purpose of promotion?
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