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Registration Form (one per child)
CROCODILE DOCK VBS MAY BE FULL. PLEASE CONTINUE WITH REGISTRATION AND YOU WILL BE NOTIFIED IF THERE IS A PROBLEM.
Child's Name:
Child's Age:
Date of Birth:
Last School Grade Completed:
Name of Parent(s):
Street Address:
City:
State:
Zip:
Home Telephone:
Cell Phone:
Email:
In Case of Emergency:
Relationship to Child:
Allergies or Other Medical Conditions:
Home Church:
Bayou Crew Number (for church use only):
Suggested donation of $20 per child ($15 per additional child(ren)). Make checks payable to HVCC (please add Children's Ministry to the memo section of your check), P.O. Box 1049, Middletown, CA 95461.
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