Van Kirk VBS Registration - 2019
Event Timing: June 17-21, 2019
9:00am to 11:30am daily
Event Address: 106 Van Kirk Rd., Monaca, PA 15061
Contact Gina at (724) 775-6884
Child's Name *
Your answer
Age *
Your answer
Grade Completed *
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Birthday *
Your answer
Parent/Guardian Name *
Your answer
Email *
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Address *
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Phone Number *
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Emergency Contact Name/Number *
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Dietary restrictions *
Medical Concerns
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Is there anything else that would be helpful for us to know about your child?
Your answer
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