Sunnyslope CRC VBS
Parent/ Guardian Name *
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Email Address *
Your answer
Primary Phone Number *
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Alternate Phone Number
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Emergency Contact (if different from primary)
Your answer
Authorized Pick-Up Person(s) *
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Address
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How did you hear about us?
Home Church
Your answer
I know of no mental or physical problems, not listed, which may affect my child's ability to safely participate in this program. I grant permission for my child to be photographed and video/audio recorded in conjunction with these activities/programs. I authorize Sunnyslope CRC's staff volunteers to secure the services of physician or hospital in the event of accident or illness, and I assume responsibility for the cost of these services and will provide repayment of these costs. *
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