Child's Name

 

Parent/Guardian Name

 

Address

 

Mailing Address (if different)

 

Phone Numbers (Home, Work & Cell)

 

E-mail

 

Birth Date   Last grade completed in school

 

Medical or other information we need to know.  (Please include any food allergies.)

 

Name    Phone Number

Name    Phone Number

 

Who may pick up your child at the end of each VBS day?

 

Do you attend Sunday School?  If so where?

If you are visiting our church, who are you a guest of?

 

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