Peace Lutheran Church ť Power Hour Registration Form

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	Power Hour Registration Form

Parents' Name

Full Address


Phone Number

Email Address

Child's Name (1)

Child's Date of Birth (1)

Child's Name (2)

Child's Date of Birth (2)

Monday Session

Tuesday session

Who will be bringing your child or children to class?


Do you have a church affiliation? If so, what?


How did you hear about us?


Do you have any questions about our program?

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