2024 VBS Registration

Child's Last Name

Child's First Name

Parent's Last Name

Parent's First Name

Parent's Email

Parent's Cellphone

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Grade child will be in next school yeat

3 yo

4 yo

K

1st

2nd

3rd

4th

5th

Emergency Contact Name

Emergency Contact Phone

(###)

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Allergies