SE Registration Form

SE Registration Form

GOSPEL WATER BRANCH BAPTIST CHURCH

FULL SUMMER ENRICHMENT PROGRAM

REGISTRATION FORM

Child's Name:*
Parent/Guardian Name:*
Address:*
Work/Cell Phone:
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Home Phone:*
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E-mail:
Last Grade Child Completed:*
T-Shirt Size:*
Please check which program child will participate in:*
Registration Fee: $50.00 Non-Refundable
Payment Type:*
Word Verification: