MC3 Church Children's Registration Form
Please complete this form to preregister your child for our database. If you have any questions, contact Rae Tyler Caggiula at caggiula@mc3.life.
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Child's Name *
Birthdate *
MM
/
DD
/
YYYY
Age
School
Grade *
Preferred Emergency Contact Number *
Mother's Name *
Mother's Cell Phone Number *
Mother's Email Address *
Father's Name *
Father's Cell Phone Number *
Father's Email Address *
Address *
City *
State *
Zip Code *
Allergies/Special Needs
Guest of
Check box if first-time visitor
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