Connect Registration 2024-2025

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Name

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

Birthdate

*

Grade

*

Please select one option.

7th 8th 9th 10th 11th 12th

Parent/Guardian/Contact Name

*

Guest of

Home Church

*

Please select one option.

Faith Baptist Other None

If other, church name:

Allergies

*

Please select one option.

Yes No

Allergies

Medical Concerns

*

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Yes No

Medical Concerns

Description

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