Vacation Bible School Registration

 

    Parent's/Guardian's Last Name:     First Names:

    Street Address:     City:     State:

    Telephone Numbers: Home     Work

    Brought by     Home Church

    In case of emergency, contact     Emergency Phone Number

 

Children's Names

    1st Child Name     Date of Birth   Last School Grade Completed

                    Gender     Allergies

                    My child would like to be with the following friends

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    2nd Child        Date of Birth   Last School Grade Completed

                    Gender     Allergies

                    My child would like to be with the following friends

---

    3rd Child      Date of Birth    Last School Grade Completed

                    Gender     Allergies

                    My child would like to be with the following friends

---

 

    4th Child      Date of Birth    Last School Grade Completed

                    Gender     Allergies

                    My child would like to be with the following friends