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Vacation Bible School
Please remember than all children will have outdoor activities; therefore, PLEASE have your child(ren) wear
CLOSED-TOE
shoes.
All preschool children MUST be potty trained. Thank you!
*
Indicates required field
Child's Name
*
First
Last
Child's Grade in the fall
*
Child's Age
*
Parent's Name(s)
*
First
Last
Street Address
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City
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Home Phone Number
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Cell Phone Number
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Allergies or Medical Conditions
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Emergency Contact Name and Number
*
Please list an Emergency contact name and phone number is other than parent listed above.
I am a member of a church
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YES
NO
If you have multiple children attending VBS, please check this box and put additional children's names and grades in the bo x below
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I have multiple children attending VBS
Please list the name(s) and grade(s) of additional children. Shirt sizes, if wanted, should be listed here too. Any medical conditions or allergies should also be listed.
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By typing my name below, I agree that the VBS workers may photograph or film the minor registered and designated on this form for any lawful purpose associated with this VBS program.
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REGISTER