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Power Lab - Register

Child Information
  Name Age Date of Birth Last Grade Completed
1.*
2.
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5.


Contact Information
Parent/Guardian:*
Email Address:
Address:
City/State/Zip: ,
Phone:
Emergency Contact:


Additional Information
Known Allergies
Who may pick up your children?
How did you find out about First Church's VBS?
Church Member/Attend First Church Sidewalk Ministry (Doorknocker Bag) A Friend Invited You Banner/Poster Other
Comments