Saylorville Baptist Church - Des Moines, Iowa » Vacation Bible School

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Vacation Bible School is only in a couple weeks! Signup today!

* Required Field

*Parent’s Name:

*Emergency Number:

ex: (555) 555-5555

*Address:

*Home Phone:

ex: (555) 555-5555

Guest of:

Church you attend regularly:

Number of Children you wish to register:

*First Child’s Name:

*First Child’s Age:

Grade completed this year:

*Second Child’s Name:

*Second Child’s Age:

Grade completed this year:

*Third Child’s Name:

*Third Child’s Age:

Grade completed this year:

*Fourth Child’s Name:

*Fourth Child’s Age:

Grade completed this year:

*Last Child’s Name:

*Last Child’s Age:

Grade completed this year:

Please list any allergies or medical concerns we should know about:

If you have any questions please contact Abe Miller

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