Children's Choirs and/or Bible Study Registration

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Fields marked with an * are required

Child's Full Name *

Grade

Age *

Date of Birth (xx/xx/xxxx) *

Address 1 *

Address 2

City *

Zip / Post Code *

Parent's Name *

Phone *

Email *

It is ok for me to be contacted by text message.

Please check which activities you would like to register for.

Emergency Contact Full Name *

Emergency Contact's Relationship to Child *

Emergency Contact Phone *