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VBS REGISTRATION FORM 2025

VBS 2025 REGISTRATION FORM JULY 21-24 from 9am-noon for Rising Kindergarten – Rising 6th Graders

Child’s First Name

Child’s Last Name

Parent’s First Name

Parent’s Last Name

Street Address

City

State

Zipcode

Parent’s Phone Number

Parent’s Email Address

Child’s Date of Birth

Child’s Grade in Fall 2025? Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade

Allergies or Medical Conditions We Should Be Aware Of:

Please share any concerns you have about your child participating at VBS:

Emergency Contact Name

Emergency Phone Number