VBS 2018
First Baptist Powell
June 20-22
9am to 12:30pm
Student Name
Your answer
Gender
Date of Birth
MM
/
DD
/
YYYY
Age
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School Attending
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Grade Just Completed
Street Address
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City
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State
Zip Code
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Name of Parent/Guardian
Your answer
Preferred Phone
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Email Address
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Primary Emergency Contact Name
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Primary Emergency Contact Phone
Your answer
Secondary Emergency Contact Name
Your answer
Secondary Emergency Contact Phone
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Special Needs/Allergies
Your answer
Is there a friend your child would like to be with? If so, please put their name.
Your answer
Where does your family attend church?
Your answer
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