VBS Registration 2018

Parent/Legal Guardian #1 *

First

Last

Parent/Legal Guardian #1 Cell Phone *

Parent/Legal Guardian #2

First

Last

Parent/Legal Guardian #2 Cell Phone

Mailing Address *

Child #1

First

Last

Gender

Grade

Child 1 Birthdate

MM/DD/YYYY

Child 1 Allergies

If none, please write 'none'

Child #2

First

Last

Gender (copy)

Grade (copy)

Child 1 Birthdate (copy)

MM/DD/YYYY

Child 1 Allergies (copy)

If none, please write 'none'

Child #3

First

Last

Gender (copy)

Grade (copy) (copy)

Child 1 Birthdate (copy)

MM/DD/YYYY

Child 1 Allergies (copy)

If none, please write 'none'

Child #4

First

Last

Gender (copy)

Grade (copy) (copy) (copy)

Child 1 Birthdate (copy)

MM/DD/YYYY

Child 1 Allergies (copy)

If none, please write 'none'

Name

Bible verse of the day

But he was pierced for our transgressions, he was crushed for our iniquities; the punishment that brought us peace was on him, and by his wounds we are healed.

Isaiah 53:5

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