* 1. Parent/Guardian Name

* 2. Street Address, City, Zip

* 3. Email Address?

* 4. Home Church?

* 5. Phone Number where  you can be reached during VBS?

* 6. Child's Name?

* 7. Age on July 23rd, 2018?

* 8. What grade will your child be in this Fall?

* 9. Does your child have any allergies?

* 10. Does your child have any special needs?

* 11. Do you have another child to register?

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