Participant's Information

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* 1. Participant's Information

Parent/Guardian names(s)

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* 2. Parent/Guardian names(s)

Participant's Birthday

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* 3. Participant's Birthday

Birthdate
Grade completed (if in school)

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* 4. Grade completed (if in school)

Gender

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* 5. Gender

Food allergies and/or medical concerns

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* 6. Food allergies and/or medical concerns

Emergency Contact Information (this person will be called if the parent/guardian(s) cannot be reached.

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* 7. Emergency Contact Information (this person will be called if the parent/guardian(s) cannot be reached.

If the parent/guardian will not be dropping of and/or picking up the child at Vacation Bible School, please list below the name(s) and contact number of the other persons responsible for drop-off/pick-up.

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* 8. If the parent/guardian will not be dropping of and/or picking up the child at Vacation Bible School, please list below the name(s) and contact number of the other persons responsible for drop-off/pick-up.

Media Permission

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* 9. Media Permission

Is there anything else we should know about your child?

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* 10. Is there anything else we should know about your child?

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