Kingdom Kids VBS Registration
Pilot Knob Missionary Baptist Church June 17th-21st 6-8:30pm
Email address *
Parent Name *
Your answer
Street Address *
Your answer
City, State *
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Zip Code *
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Phone Number
(ex. 859-555-5555)
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Emergency Number
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Emergency Contact *
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Are you a member of a church or attend a church regularly? *
If Yes, which church do you attend?
Your answer
Please select church activities you would be interested in attending.
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