Registration Form   VBS 2012

Camper Name*:____________________________________________

Gender*: M  F        Age*:__________         T-Shirt size*:_________

Grade in Fall 2012*:____________________

Address:_________________________________________________

State:_____ Zip:__________ Phone:_______________________

Parent/Guardian Name____________________________________

Work phone:_________________  Cell:______________________

E-mail address*:_________________________________________

Do you have a church home? Y/N         If yes, Where?

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