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    Child's Name*

    Your Address*


    Zip Code*

    Home Phone*

    Work Phone

    Your Email*


    Allergies/Important Medical Information*

    Emergency Contact*

    Emergency Contact's Best Phone Number*

    Birth Date*

    Grade Completed*

    Your Church

    Other Family Members Attending VBS - Name/Age/Grade Completed

    The following question helps us to avoid spam submissions.*

     Watch for more events coming soon…

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