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2019-2020 Children's Ministry Registration
Child's Infomation
Child's Name (First & Last) -1
Grade in Fall 2019: -1
*
Birthdate: -1
Allergies: -1
Do you have a second child to register?
Do you have a second child to register?
*
Yes
No
Second Child's Name (First & Last) -2
Grade in Fall 2019: -2
*
Birthdate: -2
Allergies: -2
Do you have a third child to register?
Do you have a third child to register?
*
Yes
No
Third Child's Name (First & Last) -3
Grade in Fall 2019: -3
*
Birthdate: -3
Allergies: -3
Do you have a fourth child to register?
Do you have a fourth child to register?
*
Yes
No
Fourth Child's Name (First & Last) -4
Grade in Fall 2019: -4
*
Birthdate: -4
Allergies: -4
Parent or Guardian Contact Information
Parent/Guardian Name(s):
*
Parent email:
*
Cell Phone:
*
