VBS Registration 2022

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* 1. Student name

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* 2. Grade entering

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* 3. Gender

Male

Female

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* 4. Parent contact information (please include phone number and email)

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* 5. Emergency contact information (please include phone number and email)

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* 6. Please list persons who will pick up/drop off your student

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* 7. Please list any food allergies

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* 8. Comments (please use this space to let us any additional important information- is your students coming with a friend? Are there any special, emotional or learning needs we can be mindful of?)