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July 20-24,
2009 5:45-6:15 pm Light Meal/ 6:30-8:30 pm
Classes REGISTRATION FORM
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Name___________________________________________________________________ Address________________________________________________________________ City_____________________________________________________ Zip Code______
Home Phone__________________________ Cell Phone_________________________ Parent(s) Name(s) (children only)___________________________________________ Parent(s) Work Number___________________________________________________ Emergency Contact Person and Number_____________________________________ Allergies or other Medical Conditions_______________________________________ Age (children only)_________ Last Grade Completed June 2009_________________ Person who will drop off___________________________________________________ Person who will pick up___________________________________________________ Please complete form and place it in the box located in the Welcome Center
The JESUS Chronicles A Life-Changing Encounter!
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