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2009 VBS REGISTRATION

July 20-24 † 9:00am-12noon

Deadline is July 5
Please complete a separate registration for each child

 

Grade Entering In Fall: 

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Child's LAST Name: 

Child's FIRST Name:

 

Address: (include city, state & zip

 

Parent/Guardian LAST Name:

Parent/Guardian FIRST Name:

 

EMAIL: 

 

Home Phone:  

Cell Phone: 

 

Home Church (if any):

Any Allergies/Dietary Restrictions: 

 

 

EMERGENCY CONTACT

Name: 

Phone: 

 

Please Note:  Please be sure to bring in insurance information on the first day of Vacation Bible School as you will be asked to fill out a "Medical Release" form for each child.

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After clicking on the "SUBMIT FORM" button, you will be redirected to the Home Page.  A confirmation email will be sent to you within 24hrs.  Thank you so much for your interest in our VBS program.  We look forward to meeting you!