Flash: ON   November 25, 2017 
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   Vacation Bible School June 26-30, 3-6 pm Registration for ages 3 years through 5th grade
Child / Children's Full Name & Date of Birth*
Last School Grade Completed & School Currently Attending (List for each child)*
Allergies or other medical concerns (list for each child)*
School(s) Currently Attending (List for each child)
Home Church
Complete Address & Zip*
Parent / Guardian Full Name*
Parent's Email Address*
Home Phone / Cell Phone*
Other Phone Number
Emergency Contact Name and Number (not parent)*
Names of those authorized to pick up the child*
Permission to use the child's image in a picture slideshow shown in church?


Submit

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