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VBS Registration Form
MEMBER
Yes
No
(Father) Last Name
First Name
Will you be attending VBS?
Yes
No
(Mother) Last Name
First Name
Will you be attending VBS?
Yes
No
Address
Home Phone
Cell Phone
Email Address
CHILD INFO
May we have permission to photograph
your child(ren)?
Yes
No
May we have permission to use your child's photo for the purpose of promotion?
Yes
No
Enter information for each child below.
First Name
Last Name
Age
Grade Attending in Fall
***ALLERGIES
First Name
Last Name
Age
Grade Attending in Fall
***ALLERGIES
First Name
Last Name
Age
Grade Attending in Fall
***ALLERGIES
First Name
Last Name
Age
Grade Attending in Fall
***ALLERGIES
First Name
Last Name
Age
Grade Attending in Fall
***ALLERGIES
First Name
Last Name
Age
Grade Attending in Fall
***ALLERGIES
First Name
Last Name
Age
Grade Attending in Fall
***ALLERGIES
First Name
Last Name
Age
Grade Attending in Fall
***ALLERGIES
First Name
Last Name
Age
Grade Attending in Fall
***ALLERGIES
First Name
Last Name
Age
Grade Attending in Fall
***ALLERGIES
EMERGENCY CONTACT INFORMATION
Name
Relationship
Contact Phone #
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