Child's Name:*
Parent / Guardian Name:*
Address:
Phone:*
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Cell Phone:*
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E-mail:
Birth Date:*
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Last Grade Completed by your Child? *
List ANY Medical / Food Allergies we may need to know.
Emergency Contact Name:*
Emergency Contact Phone:*
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Please Indicate names of those who may pick up your child at the end of each night. *
Does your Child attend Sunday School?*
If YES, Where?
Is your child visiting our church?
If YES, who is your child a guest of?
May We Photograph your child*
If YES, may we put photos of your child on Social Media?*