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GodSquad Registration ~ 2018 Winter Session (1/10-2/7)
Student (1) First Name *
Your answer
Student (1) Last Name *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Grade *
Nursery & PK (4 years old) class available ONLY for parents in a Wednesday night Small Group.
Allergies/Emotional Needs *
Required
Student (2) First Name
Your answer
Student (2) Last Name
Your answer
Birthdate
MM
/
DD
/
YYYY
Grade
Nursery & PK (4 years old) class available ONLY for parents in a Wednesday night Small Group.
Allergies/Emotional Needs
Student (3) First Name
Your answer
Student (3) Last Name
Your answer
Birthdate
MM
/
DD
/
YYYY
Grade
Nursery & PK (4 years old) class available ONLY for parents in a Wednesday night Small Group.
Allergies/Emotional Needs
With whom does the child(ren) reside? *
Your answer
Street Address *
Your answer
City, State, Zip *
Your answer
Mom/Guardian Name
Your answer
Mom/Guardian Cell
Your answer
Mom/Guardian E-mail
Your answer
Dad/Guardian Name
Your answer
Dad/Guardian Cell
Your answer
Dad/Guardian E-mail
Your answer
Emergency Contact Name & Number *
Necessary should Mom/Dad/Guardian be unreachable during GodSquad.
Your answer
Comments
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