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Registration for Vacation Bible School
(Ages 4 years - 5th Grade)
June 11th - 15th
9 a.m.-Noon

*Child Name
*Grade in School
*Street Address
*City, State and Zip Code
*Parent(s) Name
*Home Phone
*Work Phone
Cell Phone
*Email Address
Church Home
*Emergency Contact (Name, Phone, & Relationship)
Allergy/Heath Conditions
Would you like someone to contact you about serving on the VBS Team?