VBS: SHINE
Grades K-6th
Student's Name
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Student Grade
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Student Age
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Parent / Family / Guardian Name
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Street Address
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City / State
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Zip Code
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Email
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Home Church
Allergies/Medical Condition
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Safety Alerts
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Dismissal Information (Name (s) of people (s) who can pick up child from VBS, please type first and last name)
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Special Needs (Briefly describe any special accomidations that your child may need during VBS)
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