VBS Registration Form
St. Paul's Lutheran Church VBS - July 31-Aug 4, 2017
Student's Name *
Your answer
Parent/Guardian's Name *
Your answer
Address *
Your answer
Email address *
Your answer
Phone number *
Your answer
Age *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Last School Grade completed
Your answer
Home Church *
Allergies/Medical Information/Other
Your answer
Emergency Contact #1 (Name & phone #) *
Your answer
Emergency Contact #2 (Name & phone #)
Your answer
Who has permission to pick up this child each night from VBS? *
Your answer
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