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Ocean Commotion 2019 Registration Form
Email address *
Child's Name *
Your answer
Gender *
Birthdate *
Your answer
Grade entering this Fall *
Home address (plus city, state, zip code please) *
Your answer
Parent/Guardian name(s) *
Your answer
Home phone and/or cell number (where we can reach you during Ocean Commotion) *
Your answer
Work phone
Your answer
Email address
Your answer
Please place my child with:
Your answer
Emergency Contact *
Your answer
Relationship to child *
Your answer
Name of home church
Your answer
Food allergies *
List food allergies
Your answer
Medical Concerns? *
Explain medical concerns
Your answer
A copy of your responses will be emailed to the address you provided.
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