Locust Grove Baptist VBS Registration Form
Child's Last Name *
Your answer
Child's First Name *
Your answer
Parent/Guardian Name *
Your answer
Address *
Your answer
Phone # (Best # to reach you) *
Your answer
Birth Date *
MM
/
DD
/
YYYY
School Grade Completed *
Allergies/Medical Info we need to know
Your answer
Emergency Contact Info (Names and Numbers) *
Your answer
Dismissal Information (Who May Pick Up Your Child) *
Your answer
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