We're so excited that you want to register for Vacation Bible School! Start your registration now...
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Child's Name: *

 
Date of Birth: *

 
School Year Just Completed: *

 
School Attended: *

 
Parent's Name: *

 
Phone: *

 
Address: *

 
Do You Attend Church? Where? *

 
Emergency Contact Name: *

 
Emergency Contact Phone: *

 
Who Will Pick Up Your Child? *

 
Please List Any Health Concerns or Allergies... *

 
Additional Information You Think We Need To Know... *

 
May we take and use your child's photo for publicity purposes? *

     
We can't wait to see you at Vacation Bible School! Please call us at 225-664-4102 if you have questions or need further information. We'll be in touch...
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