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MDPC Children's Ministry Registration on Wednesday, November 17, 2021 @ 5:00 PM

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CHILD'S INFORMATION
Nickname:
*Gender
*Child's Current School:
*Does your child have Allergies/Health Concerns/Special Needs: (If none, please state none)

PARENT/GUARDIAN INFORMATION

*First Name
*Last Name
*Gender
*Birth Date
*Mobile Phone Number
*Email
*Relationship to Child
ADDITIONAL PARENT/GUARDIAN INFORMATION
*Birth Date
First Name
Last Name
Gender
Birth Date
Mobile Phone Number
Email
Relationship to Child
Questions/Comments for Children's Ministry?
*Come serve with us!  

Would you like to be contacted regarding volunteering?
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