Merrell United Methodist Church
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First Name
Last Name
Email
Message
Permission to Travel
Yes
No
Will be able to be involved in water activities
Yes
No
Is there a special medical need?
Yes
No
Is there allergies
Milk Products
Nuts
Shell Fish
Animals
Grass
Other
Do you have medical insurance for your child?
No
Yes
Parent Consent
Parent Phone Number
Email
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