JAM Registration Form
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Email *
Child's Name *
Date of Birth *
MM
/
DD
/
YYYY
Grade Level *
Does this child have any special needs, physical/mental limitations, or any special family arrangements we should be aware of? If so, please list below. *
Child's Name
Date of Birth
MM
/
DD
/
YYYY
Grade Level
Does this child have any special needs, physical/mental limitations, or any special family arrangements we should be aware of? If so, please list below.
Child's Name
Date of Birth
MM
/
DD
/
YYYY
Grade Level
Does this child have any special needs, physical/mental limitations, or any special family arrangements we should be aware of? If so, please list below.
Home address *
Parent 1 Name: *
Phone number: *
Email address: *
Address
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Parent 2 Name: *
Phone number: *
Email address: *
Address
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Emergency contact information (name & phone number): *
Suggested Donation
To help cover the costs of JAM supplies, GIFT supplies and curriculum, we're asking for a suggested donation of $30 per family. Thanks! You can give online: https://www.stjohnsspencer.com/blank-page or use your offering envelope at church.
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