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Pursuit Church SA
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-----PARENT-----
Your Name (
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)
Your Email (
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Your Cell Phone Number (
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Your Address (
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City (
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State (
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Zip Code (
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Marital Status (
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Your Relationship to the Child(ren) (
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----- SPOUSE (IF APPLICABLE) -----
Name (
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)
Spouse
Gender
Spouse
Male
Female
Spouse Phone Number (if applicable)
----- 1ST CHILD -----
Full Name
Age
Grade
DOB
Gender
Boy
Girl
Any allergies or special conditions? if no, leave blank
----- 2ND CHILD -----
Full Name
Age
Grade
DOB
Gender
Boy
Girl
Any allergies or special conditions? if no, leave blank
----- 3RD CHILD -----
Full Name
Age
Grade
DOB
Gender
Boy
Girl
Any allergies or special conditions? if no, leave blank
----- Responsible Party Initial Here -----
For safety purposes, I understand that I must present the security claim tag assigned to me or a valid photo ID in order to obtain my child(ren). from Pursuit Church Kids once they are checked in.
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