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Vacation Bible School Registration

Student Birthday *

family

friends

Age range: 4 years old as of 7/1 through completed 6th grade

Student Allergies or Special Needs

Please complete and submit the form below for each individual student. You will receive confirmation of registration within 3-5 business days

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Gender *

Boy

Girl

Parent /Guardian Email: *

Student Name: *

Student Address *

How did you hear about our VBS?

Parent/Guardian Name: *

Church Affiliation

Student Age (as of 7/1): *

Emergency Phone Number *

Grade Completed in School *

Parent/Guardian Phone *