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Vacation Bible School - 2019



Please fill out the form completely

      Boy        Girl
Name 
Address
City 
State        Zip Code 
Phone
                      Parent Cell Phone  
Parent or Guardian

Allergies/ Med Info

Emergency Contact
            Phone  
Birth Date (m/d/y)
          Age     (minimum age is 4)      
T-Shirt Size
    YXS    YS    YM    YL    YXL    AS    AM      AL    AXL
Grade Completed
           Brought By  
Home Church

 



 

        

Liberty Baptist Church  | 536 S. Victory Drive  |  Lyons, GA  30436  |  Pastor Michael Plowman

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