2018 VBS Child's Registration


Child's Information

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*Yes No
If yes, provide details on the Permission and Release form after you submit this form.
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* Required

** 3 year olds must be trained and accompanied by an adult family member serving as a VBS volunteer.

White Bluff Chapel Contact Member

Individuals Who May Pick up Child


Parent #1

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* Required

Parent #2

Fill in only the places on this form that are different than parent #1.


Questions or Comments