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Participant Registration
*Participant's First Name:  __________________________________
*Participant's Last Name:  __________________________________
*Parent/Guardian Name:  __________________________________
*Address:  __________________________________
*City:  __________________________________
*State:  __________________________________
*Zip:  __________________________________
*Primary Phone:  (______)______-________
Work Phone:  (______)______-________
*Cell Phone:  (______)______-________
Email:  __________________________________
*Birthday:  __________________________________
*Last Grade Completed:  __________________________________
*Allergies or Special Needs:  __________________________________
*Emergency Contact Name (1):  __________________________________
*Emergency Contact Phone (1):  (______)______-________
*Authorized Pickup #1:  __________________________________
May we have permission to photograph your child?:    Yes   No  (circle one)
May we have permission to use your child's photograph in church publications?:    Yes   No  (circle one)
T-Shirt Size:  __________________________________
Gender:  Male  Female  (circle one)
* Required