Pathfinders 2016/2017 Registration

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Pathfinders 2016/2017 Registration

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Last Name *

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First Name *

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Birthdate *

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Grade/Class *

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Preschool

Kindergarten

1st

2nd

3rd

4th

5th

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Street Address *

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City *

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Zip Code *

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Phone # *

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Parents Name *

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Emergency Contact Name *

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Emergency Phone # *

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Email

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Medical/Allergy Information *

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My child may be picked up by *

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Photos may be taken of my child by Bethesda Baptist for local church use only *

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Comments

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