Step
2015 VBS Registration
Graceham Moravian Church VBS
Student Name
full name
Address
where living
City
where living
State
where living
Zip Code
5 digit
Home phone number
contact number
Email
a valid email
Last school grade completed
school grade
Age
current
Mother
full name
Father
full name
Emergency contact
enter name
Emergency contact phone number
enter phone number
Allergies or other medical conditions
please list all
Home church
full name
I would like to help w/VBS
select one
Yes
No
Thanks for helping!
full name and phone please
Photo permission
select one
Yes
No
Submit
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