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YOUR INFORMATION
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YOUR NAME (REQUIRED):

YOUR EMAIL:

YOUR CELL PHONE NUMBER:

YOUR BIRTHDAY (MONTH AND DAY ONLY):

PLEASE ADD ME TO THE CHURCH EMAIL LIST TO RECEIVE CHURCH-RELATED ANNOUNCEMENTS.

PLEASE ADD ME TO THE CHURCH PHONE TREE LIST TO RECEIVE CHURCH-RELATED ANNOUNCEMENTS.

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SPOUSE'S INFORMATION (if applicable)
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SPOUSE'S NAME:

SPOUSE'S EMAIL:

SPOUSE'S CELL PHONE NUMBER:

SPOUSE'S BIRTHDAY (MONTH AND DAY ONLY):

PLEASE ADD SPOUSE TO THE CHURCH EMAIL LIST TO RECEIVE CHURCH-RELATED ANNOUNCEMENTS.

PLEASE ADD SPOUSE TO THE CHURCH PHONE TREE LIST TO RECEIVE CHURCH-RELATED ANNOUNCEMENTS.

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HOME INFORMATION
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ADDRESS:

CITY:

POSTAL CODE:

PROVINCE:

HOME PHONE NUMBER:

PLEASE ADD OUR ADDRESS TO THE CHURCH MAILING LIST TO RECEIVE SEASONAL GREETING CARDS AND OTHER OCCASIONAL MAILINGS.

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CHILD #1 (if applicable)
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CHILD #1 NAME:

CHILD #1 EMAIL:

CHILD #1 CELL NUMBER:

CHILD #1 BIRTHDAY:

CHILD #1 GRADE:

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CHILD #2 (if applicable)
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CHILD #2 NAME:

CHILD #2 EMAIL:

CHILD #2 CELL NUMBER:

CHILD #2 BIRTHDAY:

CHILD #2 GRADE:

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CHILD #3 (if applicable)
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CHILD #3 NAME:

CHILD #3 EMAIL:

CHILD #3 CELL NUMBER:

CHILD #3 BIRTHDAY:

CHILD #3 GRADE:

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CHILD #4 (if applicable)
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CHILD #4 NAME:

CHILD #4 EMAIL:

CHILD #4 CELL NUMBER:

CHILD #4 BIRTHDAY:

CHILD #4 GRADE:

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OTHER INFORMATION
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