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Register for VBS

at Yacolt Community Church

Yacolt, WA

Mon Aug 10–Fri Aug 14 AT 9 a.m.–11 a.m.

Family Information

Address

Street

Street 2

City

State/Province

Postal Code

Parent/Guardian First Name

Parent/Guardian Last Name

Email

Primary Phone

Alternate Phone

Emergency Contact

Relationship to Student

Phone Number

Student Information

First Name

Last Name

Gender

Male

Female

Birth Date

Age Group

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

6th Grade

Food Allergies

Details

Medical Concerns

Details

VBS Format Preference

I have more students to register