2016 Vacation Bible School: June 12-16 9:00am - 12:00pm

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Child's Name

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Parent / Guardian

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Email

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Phone

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Address

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Age/Grade

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4yrs-K 1st-2nd 3rd-4th 5th-6th

Emergency Contact

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Food Allergies

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Dairy Gluten Peanut Other None

Church Attendance

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I attend here at First Los Lunas! I attend somewhere else. I do not attend church

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