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The Christian Worship Center at JCMHC

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Strengthening Families Program

Registration Form

Page Title

Registrant Name (Last, First)

Registrant Email

Registrant Phone Number

OTHER PARTICIPANT INFORMATION

Other Participating Adults (first names only, separated by commas)

Relationship of Other Adults to Registrant (select all that apply to the names listed above)

Spouse

Fiance

Partner

Adult Child(ren)

Sibling(s)

Parent(s)

Other adult relative(s)

None / NA

Participating Children (first names only, separated by commas)

Relationship of Children to Registrant (select all that apply to the names listed above)

Son(s)

Stepson(s) / Partner's Son(s)

Daughter(s)

Step daughter(s) / Partner's Daughter(s)

Other child relative(s)

Thanks for signing up!

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