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2022/23 Children's Ministry Registration
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* Indicates required question
Child's Legal Name
*
Your answer
Nickname/preferred name (if applicable)
Your answer
Birthdate
*
Your answer
Address
*
Your answer
School Attending
*
Your answer
Grade during 2022/23 School Year
*
Your answer
Allergies
Your answer
Medical Concerns & Medications
Your answer
Special Interests & Activities
Your answer
What would you like me to know about your child? Any behavioral or learning concerns I can prepare for? Sensitive conversation topics I can be aware of?
Your answer
Parent/Guardian Name(s)
*
Your answer
Parent/Guardian Email(s)
*
Your answer
Parent/Guardian Phone Number(s)
*
Your answer
Are there any new types of events you would like to see in the coming year?
Your answer
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