Level Up: Summer Fun Nights
JUNE 12th-15th - 6:00-8:00 PM
Entering 9th-12th Grade in the Fall
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PARENT/GUARDIAN *
FIRST AND LAST NAME
EMAIL *
PHONE # *
ADDRESS *
Address, City, State, Zip
Student 1 First and Last Name *
Current Grade Entering Fall of 2023 *
Choose only one.  Use Class instead of age if possible.
List any allergies or medical concerns we need to be aware of.
Do you have a church home?
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I have an additional student to register. *
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