Dallas Center Dunkard Brethren Church | Vacation Bible School | Registration

REGISTER FOR VBS

We are excited you are registering for VBS. Please complete the registration form to register your child/children for the 2025 VBS at Dallas Center Dunkard Brethren Church.

- Parental Information
  
  Parent / Guardian First Name: *
  
  Parent / Guardian Last Name: *
  
  Relationship: *
  
  Child Information
  
  Has Your Child Previously Attended Dunkard Brethren Church VBS?: *
  
  Child's Full Name: *
  
  Child's Date Of Birth: *
  
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  Child's Full Name:
  
  Child's Date Of Birth:
  
  ADD ANOTHER CHILD
  
  Child's Full Name:
  
  Child's Date Of Birth:
  
  ADD ANOTHER CHILD
  
  Child's Full Name:
  
  Child's Date Of Birth:
  
  ADD ANOTHER CHILD
  
  Child's Full Name:
  
  Child's Date Of Birth:
  
  ADD ANOTHER CHILD
  
  Child's Full Name:
  
  Child's Date Of Birth:
  
  ADD ANOTHER CHILD
  
  Child's Full Name:
  
  Child's Date Of Birth:
  
  ADD ANOTHER CHILD
  
  Child's Full Name:
  
  Child's Date Of Birth:
  
  Contact Information
  
  Address: *
  
  City: *
  
  State: *
  
  Zip: *
  
  Your Primary Phone Number: *
  
  Your Email Address: *
  
  Emergency Information
  
  Emergency Contact Name: *
  
  Emergency Contact Type: *
  
  Emergency Contact Phone Number: *
  
  Does Your Child / Children Have Any Of The Following? *
  
  Please List Your Child's Name And Their Medical Conditions Or Allergies:
  
  Publicity Information
  
  Where Did You Hear About The Dunkard Brethren Church VBS?: *

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