Worship 10:00am 244 E. Army Post Rd., Des Moines, Iowa, 50315

City Church

Love God… Love People… Serve Everyone

VBS 2016 Registration

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Child's Name:
Date of Birth:
Age:
Parent/Guardian Name:
Phone Number:
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E-mail:
Home Address:
Home Church:
Allergies or other medical concerns:
Emergency Contact:
Relationship to child:
Emergency Phone Number:
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