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First Church

of Christ

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Guardian First name*

Guardian Last name*

Email*

Phone*

Child First & Last Name*

Grade Completed*

Child First & Last Name

Grade Completed

Child First & Last Name

Grade Completed

Child First & Last Name

Grade Completed

Child First & Last Name

Grade Completed

Please List Any Food Allergies

Who Can Pick Up Your Child: First and Last Name*

Emergency Contact First & Last Name*

Emergency Phone Contact #*

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