VBS Registration
Child #1 Name
Child #1 Birthdate
Child #1 Grade Entering in Fall
Child # 1 own a Bible?
Child #2 Name
Child #2 Birthdate
Child #2 Grade Entering in Fall
Child # 2 own a Bible
Child #3 Name
Child #3 Birthdate
Child #3 Grade Entering in Fall
Child # 3 own a Bible
Child #4 Name
Child #4 Birthdate
Child #4 Grade Entering in Fall
Child # 4 own a Bible
Street Address for family
City
State
Zip
Phone number where you can be reached during VBS*
Parent E-Mail
Parent(s) name(s)
In case of emergency, contact
Allergies or other medical conditions (please explain allergy/medical condition and which child is affected)
Name of home church if any
How did you hear about our VBS? (Please mark one)
Any other information to share about our child(ren)


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