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Include medications foods etc. Does your child have any medical or special needs including medications currently being used No Yes If yes please explain. Doctor s Name Dentist s Name Date of last tetanus shot. Green Meadow Church of God 610 W. Hunt Rd. Alcoa TN 37701 VBS Registration Form July 10 - 12 6 30 p.m. 9 00 p.m. July 13 Family Night 7 00 p.m. Name Birthdate School Grade just completed Street address City State Home phone Cell phone E-mail Parent s name s In case of emergency...
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