r REGistRAtioN ~ORM(One Per Child)

Shirt Size _

Child's name: _

Child's age: Date of birth: _ Last school grade completed: _

Name of parentis): _

Street address: ~ _

City: ---'--'- _ State: --'- __ ZIP: _

Hometelephone:(~ ~ _

Parent/caregiver's cell phone: (L__ ---" ----.: _

Home e-mail address: _

Homechurch: _

Crew number or name (for church use only): _

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