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Student Information Form
Welcome to LPC Youth! Tell us more about you so that we can send you updates and notifications about future LPC Youth events!
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First Name
*
Your answer
Last Name
*
Your answer
Email (If you have one)
Your answer
Parent's Email (If you know it)
Your answer
Phone Number (If you have one)
Your answer
Parent's Phone Number (If you know it)
Your answer
House Address
Your answer
Name of School
Your answer
Grade in School (2021-2022)
*
6th
7th
8th
9th
10th
11th
12th
Birthday
*
MM
/
DD
/
YYYY
T-Shirt Size
*
XXS
XS
S
M
L
XL
XXL
Parents Names
*
Your answer
Allergies??
Your answer
Does your family attend LPC on Sunday mornings?
*
Yes
No
Would you like to receive LPC Youth TEXT updates (eventually)?
*
Yes
No
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