Event Registration

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WOW Rehearsals on Wednesday, January 22, 2020 @ 6:00 PM

Please provide the information below as a part of your registration.
If RUMCK: Teacher Name:
*Grade Level 2018-2019 school year:
Insurance Company:
Policy Number:
Group Number:
*Special Needs or Medication:
Please explain special needs and medication:
*allergies (drugs, foods, ect.):
Health Conditions and Physical Limitations:
Date of Last Tetanus:
Home Church:
*Parent/ Guardian Names:
*Parent/ Guardian Address(es):
*Parent/ Guardian Phone Number:
*Emergency Contact:
*Emergency Contact Phone:
*T-shirt Size: