VBS 2024
Please fill out this form and click submit.
Name
*
Parent/guardian
*
Phone
*
Email
*
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Age
*
Please select one option.
3 yr
4 yr
5 yr
Completed Kindergarten
Completed 1st
Completed 2nd
Completed 3rd
Completed 4th
Completed5th
Emergency Contact
*
Phone
*
Emergency Contact
*
Phone
*
Medical Info
*
Who may pick up your child at the end of VBS each day?
*
Do we have permission to photograph/video your child?
*
Please select one option.
YES
NO
Do you actively attend church? If so, What church?
*
Submit
Description
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