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Vacation Bible School 2010 : Pre-Registration

Complete this online form to pre-register for the event to aid our VBS workers in planning for this year's attendance.

Notes:

  • Children must be from age 4 to completed 6th grade.
  • Required fields in the form below are marked with *

Child's information

Last name * : Last name is required. First name * : First name is required.
Gender * : Please select a gender.
Age * : Please select an age. Grade level completed * : Please select a grade.
Allergies or medical conditions :

Parent or Guardian Information

Last name * : Last name is required. First name * : First name is required.
Relationship: e-mail * : E-mail address is required.Use valid e-mail format.
Street Address:
City: State ZIP
Primary phone * : Primary phone is required.Use valid phone number format. Alternate phone:
Emergency Contact (Name and Number):


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