Mountain Movers Registration
2017 - 2018
Sundays 6:30pm - 8:00pm
Shannon Hills Bible Chapel
900 W Vandalia Rd
Greensboro, NC 27406
Email address *
Please do not combine registrations for multiple children; complete a separate form for each child attending Mountain Movers.
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Address 1 *
Your answer
Address 2
Your answer
City *
Your answer
State/Province *
Your answer
Zip Code *
Your answer
Additional Emergency Contact
Please list name & phone number for additional emergency contacts.
Your answer
Parent/Guardian Phone Number *
Your answer
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