General Information
Contact Information
Child Name *
Parent/Guardian Name *
Address *
(street address, city, state, and zip code)
Contact Phone Number *
Email Address *
Child's Birthday *
MM
/
DD
/
YYYY
Last Grade Completed in School *
Does your family attend church at LifeStream?
If no, where do you attend?
Will you be attending the kickoff event at noon on August 2nd at LifeStream? *
Would you like to register another child? *
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