VBS Gateway 2024
*
Child
First Name
*
Child
Last Name
*
Child
Birth Date
* Grade entering in the fall
* Parent/Guardian: First and Last name
* Parent/Guardian: Email
* Parent/Guardian: Cell
Parent/Guardian: Work
* Physical Address
Mailing address (If different then physical)
* 1st - Emergency Contact (name and phone)
* 2nd - Emergency Contact (name and phone)
* Medical Information (include allergies and any other medical or other information we should know)
* Who is authorized to pick up child after VBS each day?
* Do you currently have a home church?
Select one
Yes
No
If yes, what church is your home church?
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