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VBS Registration
June 11-15 5pm - 7:30pm
Seeds of Hope - Mondo Anaya Community Center, 1487 N Crane Street, Casa Grande, Arizona
Presented by Desert Sky Baptist (520-421-3377) and Providence Reformed Baptist (520-477-7450)
Parent or Guardian Information
E-Mail:*
First Name:*
Last Name:*
Address Line 1:*
Address Line 2:
City:*
State:*
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Zip Code:*
Phone:*
Emergency Contacts (list names and phone numbers)
Who is permitted to pick up the children?
If the children attend church, please list the name of the church
Child Information (1)
First Name:*
Last Name:*
School grade completed this year:
Age:*
Date of Birth
Allergies
I have a second child to register
Child Information (2)
First Name:
Last Name:
School grade completed this year:
Age:
Date of Birth
Allergies
I have a third child to register
Child Information (3)
First Name:
Last Name:
School grade completed this year:
Age:
Date of Birth
Allergies
I have a fourth child to register
Child Information (4)
First Name:
Last Name:
School grade completed this year:
Age:
Date of Birth
Allergies
I have a fifth child to register
Child Information (5)
First Name:
Last Name:
School grade completed this year:
Age:
Date of Birth
Allergies
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