GLOSTER STREET CHURCH OF CHRIST
VBS 2025 REGISTRATION FORM
Parent/Guardian Name
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Home Mailing Address
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Parent/Guardian Cell Phone
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Please enter a valid phone number.
Emergency Contact Name
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Emergency Contact Phone Number
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Please enter a valid phone number.
Child Name1
*
Date of Birth1
*
/
Month
/
Day
Year
Date
Age1
*
Grade in Fall1
*
Other special instructions medical allergies etc1
Child Name2
Date of Birth2
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Month
/
Day
Year
Date
Age2
Grade in Fall2
Other special instructions medical allergies etc2
CHILD 3
Child Name3
Date of Birth3
/
Month
/
Day
Year
Date
Age3
Grade in Fall3
Other special instructions medical allergies etc3
CHILD 4
Child Name4
Date of Birth4
/
Month
/
Day
Year
Date
Age4
Grade in Fall4
Other special instructions medical allergies etc4
CHILD 5
Child Name5
Date of Birth5
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Month
/
Day
Year
Date
Age5
Grade in Fall5
Other special instructions medical allergies etc5
CHILD 6
Child Name6
Date of Birth6
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Month
/
Day
Year
Date
Age6
Grade in Fall6
Other special instructions medical allergies etc6
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