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Vacation Bible School

2019 Vacation Bible School

Dates: June 17-19

Times: 9:00am-Noon
Wednesday free dinner for all VBS attendees and parents from 6:15-7:00pm!

Ages: Classes for ages 4 years old to 5th grade!

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Parent/Guardian Information
Parent/Guardian Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Cell Phone*
Are you the emergency contact for the child(ren) registered?*
- Yes
- No
Emergency Contact Name*
First Last
Emergency Contact Email*
Emergency Contact Cell Phone*
Student Information
Register Students
Child Name
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Child Name
First Last
Child's Class
Gender
- Male
- Female
T-Shirt Size
Does the child have any food allergies or special needs?
- Yes
- No
Please describe:
Parent Name
First Last
Parent Phone
Address
Street Address Address Line 2 City State ZIP Code
Parent Email
Emergency Contact (if different)
First Last
Emergency Email
Emergency Phone