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Child's Name
Parent/Guardian Name
Address (please list street city and zip code.)
Phone Number
Birth Date
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Dismissal Information
Who may pick up your child at the end of each VBS day?
Other Information
Does your child attend Sunday School? If so where?
May we have permission to photograph your child?
Select One
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May we have permission to use your child’s photograph for the purpose of promotion?
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Last Grade completed
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