VBS 2025 Wonder Junction
Please fill out this form and click submit.
General Information
Name of Parents/Guardian
*
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Home Phone
*
Cell Phone
*
Emergency Contact Information
Emergency Contact Name
*
Emergency Contact Phone
*
Emergency Contact Relationship to Child
*
We Release children ONLY to parents or adults who are listed below
Adult #1
*
Adult #2
*
Adult #3
*
Do you give permission for pictures to be taken of your child and/or posted on social media platforms to promote Mountain Movers' Children Ministry and or VBS
*
Please select all that apply.
Yes
No
Information on Children - Infants thru 5th Grade
Name
*
Gender
*
Please select one option.
Male
Female
Age
*
Date of Birth
*
Grade
*
School System
*
Food Allergies/Medical Concerns
*
Other Information
*
Submit
Description
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