VBS 2017
VBS 2017
First Name of Child  * 
Last Name  * 
Child Gender  * 
Age  * 
Grade (2017-2018 school year)  * 
Parent Name (First and Last)  * 
Street Address  * 
State, Zip  * 
Emergency Contact Name  * 
Emergency Contact Phone Number  * 
Does your child have any food allergies?  * 
If yes, please list them.
Will your child be bringing any medication to this event?  * 
If yes, please list medication here.
If your child is bringing any medication, please put it in a clear plastic bag with the child’s name written on the front.
Your Email Address  * 
T-Shirt (optional) Limited quantities available. Available for purchase until June 1.  * 
Dinner is now available for purchase until June 1st. Dinner will be served Monday-Wednesday of VBS from 5:30-6:00. The cost is $15 for 3 nights.  * 
Total $
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