| 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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My child will be participating in the Afternoon Mission
opportunities.
This Afternoon Mission Program is offered
Monday, Tuesday and Wednesday for children that have completed
3rd through 6th grades. Your child will need to bring a lunch
each day. |
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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
childs parents/guardians cannot be reached, please notify: |
| Name: |
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| Phone: |
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