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2019 VBS Registration Form

WYLDWOOD BAPTIST CHURCH

2019 VBS REGISTRATION FORM

 

STUDENT NAME _______________________________________________________

AGE  _______________     GRADE JUST COMPLETED _______________________

NAME OF CHURCH _____________________________________________________

ALLERGIES, MEDICAL ISSUES, SPECIAL NEEDS: ________________________________________________________________________

PARENT NAME _____________________________________________________________

ADDRESS ___________________________________________________________________

_________________________________________________________________________

PHONE ________________________ EMAIL __________________________________

EMERGENCY CONTACT & PHONE ____________________________________________

_________________________________________________________________________

MEDICAL RELEASE ____    PHOTO RELEASE ____ PERMISSION TO ATTEND ______

 

PARENT SIGNATURE ______________________________________  DATE ___________