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6:30-8:45pm

June 13, 2022

VBS 2022 Registration

Child's Full Name

Fall 2022 Grade

Email

Phone

Mailing Address

Parent/Guardian Name(s)

Emergency Contact (phone #)

Allergies

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CityLight Baptist Church

1121 Sperryville Pike

Culpeper, VA 22701

540.321.4400

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