Adelaide Pentecostal Fellowship
VBS 2022
Student registration form
Child 1
*
First Name
Middle Name
Last Name
Date of birth
*
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Day
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Month
Year
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Child 2
First Name
Middle Name
Last Name
Date of birth
-
Day
-
Month
Year
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Child 3
First Name
Middle Name
Last Name
Date of birth
-
Day
-
Month
Year
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Child 4
First Name
Middle Name
Last Name
Date of birth
-
Day
-
Month
Year
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Address
*
Please enter your full address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number in case of any emergency happens.
Allergies/ Special requests
Do let us know if you have any special requirements to be taken care of.
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