Covenant VBS Registration
Child's Name
Your answer
Child's Birthdate
MM
/
DD
/
YYYY
Grade Completed
Child's Address
Your answer
Parent or Guardian's Name
Your answer
Parent or Guardian's Phone Number
Your answer
Parent or Guardian's Email Address
Your answer
Emergency Contact Name
Your answer
Emergency Contact Phone Number
Your answer
Backup Emergency Contact Name
Your answer
Backup Emergency Contact Number
Your answer
Allergies (food, insects, etc.)
Your answer
Child's Image
Other (anything else we should know about your child)
Your answer
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