Versailles Baptist Church Guest Registration
ADULT / PARENT INFORMATION
First Name *
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Last Name *
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Marital Status *
Date of Birth *
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Name of Spouse (if applicable)
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Spouse's Date of Birth
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Street Address *
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Address Line 2
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City *
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State *
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Postal / Zip Code *
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Home Phone
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Cell Phone
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Email Address *
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Are you a member of another church?
If yes, name of church:
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What services will you be attending?
(check all that apply)
I would like more information on:
(Check all that apply)
IF YOU ARE NOT REGISTERING CHILDREN, PLEASE SKIP TO THE END AND PRESS SUBMIT.
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Child # 1 Full Name
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Child #1 Date of Birth
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YYYY
Child #1 Gender
Child #1 Grade
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Child #1 Age
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Child #1 Allergies / Special Needs
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Child # 2 Full Name
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Child #2 Date of Birth
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DD
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YYYY
Child #2 Gender
Child #2 Grade
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Child #2 Age
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Child #2 Allergies / Special Needs
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Child # 3 Full Name
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Child #3 Date of Birth
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DD
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YYYY
Child #3 Gender
Child #3 Grade
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Child #3 Age
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Child #3 Allergies / Special Needs
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