| Child's First Name: |
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| Child's Last Name:
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| Home Address: |
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| City: |
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| State: |
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| Zip: |
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| Phone: |
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| Email: |
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| Gender: |
Male
Female |
| Age (by April): |
years |
| Last Grade Completed: |
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| T-Shirt Size |
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Please list the name
and a phone number of where you can be reached during the week of
VBS. |
| 1. Parent/Guardian
Name: |
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| Phone: |
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| 2. Parent/Guardian
Name: |
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| Phone: |
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| Child's Home Church
(if any) |
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Please complete
the following information regarding transportation to and from
Vacation Bible School:
My
child has permission to leave independently
Picked
up by parent(s) or adults listed:
**Adults not listed will need written
permission to leave with your child.
**Photo identification will be requested by any person signing out a
child from VBS. |
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By checking this box I state that I am willing for any photos of my
child taken during VBS to be used in media and publications (closing
power point presentation, web site, newsletter, etc.). Names WILL
NOT be included. |
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Please share any
helpful information about your child (special interests/hobbies,
family, pets, etc.) and please let us know of any days your child
will not be attending |
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Medical
Information |
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Please list any
behavior, physical/emotional/mental health issues, etc. of which the
staff should be aware: |
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Important: If your
child is required to take any type of medication during the school
year, please have your child take it during the week of VBS. Thank
you! |
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If both of the
child's parents/guardians cannot be reached, please notify: |
| Name: |
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| Phone: |
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