York Bible Church - VBS Registration 2016
Parent/Guardian Name
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Email Address:
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Mailing Address (street, city, zip code)
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Emergency Contact Number
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Home Phone Number
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Child's Name (Child 1)
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Date of Birth (Child 1)
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DD
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YYYY
Entering Grade (Child 1):
2nd Child's Name
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Date of Birth (Child 2)
MM
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DD
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YYYY
Entering Grade (Child 2):
3rd Child's Name
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Date of Birth (Child 3)
MM
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DD
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YYYY
Entering Grade (Child 3):
Comments for All Kids (Include Allergies and Medical Conditions)
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Home Church (if any)
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