iBlast/iGnite Registration
Register to attend the Fall 2020 sessions beginning October 6th, 2020
Child's Full name *
Child's Age *
Birth Date *
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DD
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Boy/Girl *
Current Grade Level *
School My Child Attends *
Parent or Guardian's Name *
Home Address, City, State, Zip *
Home Phone
Work Phone
Cell Phone
Email
Home Church
Emergency Pick-Up #1 Name *
Emergency Pick-Up #1 Phone *
Emergency Pick-Up #2 Name
Emergency Pick-Up #2 Phone
Food Allergies/Medical Concerns (provide details)
I give permission for my child's photo, audio or video recording to be used to promote Good News Clubs
Submit
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