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Village Adventure ROAR VBS Application
July 19 - 23, 2021 | 6:00pm - 8:30pm
Event Address: 1010 E. Alice Ave.
Contact us at (602)944-2275 or
nvbc1010@northvillage.org
with any questions.
- Please fill out a form for EACH child you are wishing to register -
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Email
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Your email
Child's name (first and last):
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Your answer
Child's gender
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Female
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Child's age
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Your answer
Date of birth:
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DD
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YYYY
Last school grade completed:
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Your answer
Name of parent(s):
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Your answer
Street address:
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City:
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State:
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Your answer
ZIP:
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Your answer
Parent/caregiver's phone number:
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Your answer
Home church (if any):
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Your answer
Any allergies or other medical conditions?
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In case of emergency, contact:
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Emergency contact phone number:
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Emergency contact's relationship to child:
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