2021 VBS Registration Wyatt Park Christian Church
Preschool-3rd grade VBS and 4th-6th grade Jr Missions
Student's Name *
Date of Birth *
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Age *
School last attended
Grade last completed 2020-2021 *
Parent/Guardians name (s) *
Address
Primary Phone number
Emergency Contact *
Phone number of emergency Contact *
known Allergies or medical concerns
I give permission for my child to be photographed with images potentially used on our Facebook page. *
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