CHRIST CHURCH KIDS REGISTRATION

Parent/Guardian Name

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Phone

Address

Do any of the below children have allergies / conditions we should be aware of? If not, please write

Child #1's name

Child #1's birthdate

Child #2's name

Child #2's birthdate

Child #3's name

Child #3's birthdate

Child #4's name

Child #4's birthdate

Additional children's names and birthdates:

Description

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