Summer Meditations - Trinity Lutheran Church of Quakertown, PA
Summer Meditations - Trinity Lutheran Church of Quakertown, PA
Summer Meditations - Trinity Lutheran Church of Quakertown, PA
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Name __________________________________ Grade Entering _________<br />
Address ______________________________________________________<br />
Phone _______________________________________ Age __________<br />
Emergency Phone _____________________ e-mail ___________________<br />
Parent Name ______________________________________<br />
Emergency Contact ___________________________________<br />
Alternate Pick-up _______________________________________________<br />
Allergies _________________________ Food Allergies ________________<br />
Doctor’s Name and Phone _______________________________________<br />
Circle Shirt Size: Child S M L<br />
Adult S M L XL<br />
In case <strong>of</strong> emergency, I authorize <strong>Trinity</strong> <strong>Lutheran</strong> <strong>Church</strong> to take the<br />
appropriate measures to treat my child.<br />
Signature _______________________________________ Date_________