2017 VBS Youth Helper Registration
 
2017 VBS Youth Helper Registration
Youth helper first name  * 
Youth helper last name  * 
Youth helper’s age  * 
Home telephone #  * 
Your Email Address  * 
Parent’s/ Caregiver’s name(s)  * 
Parent’s/ Caregiver’s cell phone  * 
Parent’s/ caregiver’s cell phone (if additional)
Allergies or medical conditions  * 
My youth helper requires an epi pen.  * 
Emergency contact if parent/ caregiver can not be reached  * 
Emergency contact phone number  * 
Where would you like to help?  * 
Enter any special requests here (specific grade, friend you'd like to work with, etc.)
 
 
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