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Registracion del Participante

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Bell Shoals Baptist Church

Location

6414 Golf and Sea Blvd

Apollo Beach, FL 33572

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Contact Isabelle Armstrong:

8136412222 ex. 104

isabelle.armstrong@bellshoals.com

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Información de los Padres

Register kids who have completed K - 5th grade. Please select grade COMPLETED. Do not register your child younger than completed Kindergarten unless you have been approved as a volunteer by our staff.

Nombre

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Apellido

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Correo Electrónico

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Dirección 1

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Dirección 2

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Ciudad

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Estado/Provincia

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ZIP/Código Postal

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Teléfono de Contacto 1

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Teléfono de Contacto 2

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Nombre del Contacto de Emergencia

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Relación del Contacto de Emergencia

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Teléfono del Contacto de Emergencia

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List up to three persons you authorize to pick up your child and their phone number.

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Do you attend a local church?

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Cuéntanos sobre tu participante

Nombre

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Apellido

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Grado Saliendo

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Género

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Fecha de nacimiento

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Talla de Camisa

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Alergias

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Preocupaciones Médicas

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¿Tienes amigos con los que te gustaría estar juntos? Haremos todo lo posible para juntar a los amigos seleccionados en el mismo grupo, pero no podemos prometer que todas las solicitudes serán posibles.

Amigo 1 Nombre

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Amigo 1 Apellido

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Amigo 2 Nombre

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Amigo 2 Apellido

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Amigo 3 Nombre

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Amigo 3 Apellido

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Comentarios

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