The Connecting Point Registration Form

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Enter Full Name:
First Name
Middle
Last Name
Your Birth Date:
Spouse's Full Name
First Name
Middle
Last Name
Spouse's Birth Date:
Home Address:
Address Line 1
Address Line 2
City
State
Postal Code
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Name of Child living at home:
First Name
Middle
Last Name
Age:
If Student enter grade:
School Child Attends:
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Name of Child Living at home:
First Name
Middle
Last Name
Age:
If Student enter grade:
School Child Attends:
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We will be attending the class currently scheduled.

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Home Phone:
Cell Phone:
Spouse's Cell Phone:
Email Address:
Re-enter Email Address:
I would like to receive the Church Newsletter by email:
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Name of Child living at home:
First Name
Middle
Last Name
Age:
If Student enter grade:
School Child Attends:
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Name of Child living at home:
First Name
Middle
Last Name
Age:
If Student enter grade:
School Child Attends:
______________________________________________________