FPC VBS Registration 2014-Weird Animals
Child's first name
*
Child's last name
*
Birth Date
Please select a month
January
February
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July
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Month
Please select a day
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Day
Please select a year
2024
2023
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2014
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Year
Child's Age
*
Grade entering in Fall
*
Parent/Guardian First Name
*
Parent/Guardian Last Name
*
Home/Work Phone
*
Cell Phone
*
Street Address
*
City
*
State
*
Zip Code
Parent/Guardian Email
*
Emergency Contact
Emergency Contact Number
*
Emergency Contact Phone
*
Emergency Contact Relationship
*
Home Church
Allergies/Food restrictions
I hereby give my consent for any emergency medical or surgical care which may be needed and deemed necessary to my child named above while participating in VBS at Felton Presbyterian Church, July 28th-August 1st, 2014. I understand a reasonable attempt will be made to contact me before use of this consent is made. (Parent/guardian type name in text box as consent)
I understand that there is a cost of $20 per child. I understand that scholarships are available and can request one if needed.
Submit
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