GLOSTER STREETCHURCH OFCHRIST
VBS 2026 REGISTRATION FORM
Parent/Guardian Name
Home Mailing Address
Parent/Guardian Cell Phone
Format: (000) 000-0000.
Emergency Contact Name
Emergency Contact Number
Format: (000) 000-0000.
CHILD 1
Name
Date of Birth
-
Month
-
Day
Year
Date
Age
Grade in Fall
Other (special instructions, medical, allergies, etc.):
CHILD 2
Name
Date of Birth
-
Month
-
Day
Year
Date
Age
Grade in Fall
Other (special instructions, medical, allergies, etc.):
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CHILD 3
Name
Date of Birth
Age
Grade in Fall
Other (special instructions, medical, allergies, etc.):
CHILD 4
Name
Date of Birth
Age
Grade in Fall
Other (special instructions, medical, allergies, etc.):
CHILD 5
Name
Date of Birth
Age
Grade in Fall
Other (special instructions, medical, allergies, etc.):
CHILD 6
Name
Date of Birth
Age
Grade in Fall
Other (special instructions, medical, allergies, etc.):
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