VBS Kids Registration
July 22-24, 2019 * 6-8pm
2 Yr Olds - 5th Grade
Age Group *
Child Info
Child's First Name *
Your answer
Child's Last Name *
Your answer
Gender *
Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Grade Fall of 2019 *
Your answer
Church Attending *
Your answer
Medical Info
Medical or other info we need to know. (Please include food allergies) *
Your answer
Parent Info
Parent or Guardian's Name(s) *
Your answer
Cell # *
Your answer
Email *
Your answer
Emergency Contacts (other than parent or guardian) *
Your answer
Cell # *
Your answer
Emergency Contacts *
Your answer
Cell # *
Your answer
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