Vacation Bible School 2017
 
Vacation Bible School 2017
Child’s Name  * 
Parent/Guardian Name  * 
Street Address  * 
City  * 
State  * 
Zipcode  * 
Phone Number (Home)
Phone Number (cell)
Date of Birth
Last Grade Completed in School
Do You Attend Sunday School?  * 
If you attend Sunday School, what church?
Medical Information - Please Include Food Allergies.
Emergency Contact - Name / Phone Number
By submitting this form I understand that I must present the appropriate documents (given to me at registration) in order to receive my children at the end of each evening.
May PGBC have permission to photograph your child?  * 
May PGBC have permission to use your child’s photograph for the purpose of promotion?  * 
Your Email Address  * 
 
 
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