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2023 Vacation Bible School
Pre-Registration for Vacation Bible School 2023
First Name
*
Please enter the registrant's first name.
Last Name
*
Please enter the registrant's Last Name.
Street Address
*
Please enter your Street Address.
City
*
Please enter your City.
Phone Number
*
Please enter a valid phone number (123-456-7890).
Date of Birth
*
Month
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Day
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Year
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Zip Code
*
Please enter your Zip Code.
Email
*
Please provide your email address.
Age as of July 1st
*
Please enter child's age.
School Grade Completed
*
k3
k4
k5
01
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06
Please choose the most recent school grade completed.
Name of church attended
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Name of Parent(s)
*
Please enter the name of the child's parents.
Need a ride?
*
No
Yes
Please indicate if a ride is required for the child to attend.
Pickup location
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Allergies or Special Diet Instructions?
*
Please indicate if the child has any allergies or special diet needs. If no exist, please type N/A.
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