Vacation Bible School

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					                    Vacation Bible School                                             Vacation Bible School
                     Registration Form                                                 Registration Form
                     July 21-25, 2008                                                  July 21-25, 2008
Child’s Name: ____________________________________________        Child’s Name: ____________________________________________

Age/Birthday/Grade: ________/______________/_______________       Age/Birthday/Grade: ________/______________/_______________

Street Address: ___________________________________________       Street Address: ___________________________________________

City: ________________ State: __________ Zip: _____________       City: ________________ State: __________ Zip: ______________

Home Telephone: ___________-__________-___________________        Home Telephone: ___________-__________-___________________

Parent/Caregiver’s Cell Phone: ________-_________-____________    Parent/Caregiver’s Cell Phone: ________-_________-____________

Home e-mail: ____________________________________________         Home e-mail: ____________________________________________

Last School Grade Completed: _______________________________      Last School Grade Completed: _______________________________

In Case of Emergency Contact: _______________________________     In Case of Emergency Contact: _______________________________

________________________________________________________          ________________________________________________________

Mother: _________________________________________________         Mother: _________________________________________________

Father: __________________________________________________        Father: __________________________________________________

Other: __________________________________________________         Other: __________________________________________________

Allergies or other Medical Conditions: ________________________   Allergies or other Medical Conditions: ________________________

________________________________________________________          ________________________________________________________

Home Church: ___________________________________________          Home Church: ___________________________________________

				
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