VBS 2023 Registration Form  
Vacation Bible School
Monday, June 19th-23rd
2424 Norkenzie Rd Eugene OR  97408

5 years old-5th grade (completed)
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Email *
Jesus Is the Light of the World
Child's name *
Grade Completed *
Age *
Gender *
Food Allergies *
Street Address *
City *
State *
Zip Code *
Parent/ Guardian *
Phone Number *
Email Address *
Emergency Contact *
Emergency Contact Phone Number *
Medical Information (Please list any serious medical conditions) *
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