Missio Dei LA
Kids Ministry Registration
Today's Date
MM
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DD
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YYYY
Child Legal Name (first & last) *
Your answer
Preferred Nickname
Your answer
Child's Birthdate *
Your answer
Responsible Parent/Guardian Name *
Your answer
Parent/Guardian Contact Number # *
Your answer
Allergies of any kind?
Your answer
Any medical concerns or special needs?
Your answer
Please list any siblings who will also be joining us for Sunday School (please fill out a separate form for each child.)
Your answer
Please name any other adult permitted to pick up or drop off this child:
Your answer
Anything else we should know?
Your answer
Anyone who specifically is NOT allowed to pick up your child from Sunday School?
Your answer
Would you like to be added to the email list?
Guardian's Email Address
Your answer
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