-STUDENT FIRST, MIDDLE, AND LAST NAME

-GENDER

-STUDENT AGE

-PASTOR'S NAME

-CHURCH NAME

-CONFIRM YOU WILL SEND/BRING A PASTORAL APPROVAL LETTER

-EMERGENCY CONTACT NAME

-EMERGENCY CONTACT RELATION TO STUDENT

-EMERGENCY CONTACT PHONE NUMBER

-ALLERGIES OR ILLNESS LISTED

-CONFIRM IF THE STUDENT REQUIRES DAILY MEDICATION

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