Maker Fun Factory VBS June 26-30, 2017 9:00 AM-12:15 PM
 
Maker Fun Factory VBS June 26-30, 2017 9:00 AM-12:15 PM
Child’s First Name:  * 
Child’s Last Name:  * 
Street Address:  * 
City:  * 
State:  * 
Zip Code:  * 
Primary Contact Phone:  * 
Alternate Phone:
Date of Birth:
Age:  * 
Gender (select):  * 
School grade completed June 2017 (select):  * 
Parent Name(s):  * 
Person Completing This Form:  * 
Person Picking Up Child:  * 
Alternate Pickup Person:
Emergency Contact Name:  * 
Emergency Contact Phone Number:  * 
Church Affiliation:  * 
Allergies or Other Medical Conditions:
How did you hear about Maker Fun Factory?  * 
Name of a friend child might like to be with:
Note: We will do our best to accommodate this, but cannot guarantee it.
Siblings attending Maker Fun Factory:
Your Email Address  * 
Looking forward to having you with us!
 
 
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