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I'm New What to Expect Connect Card B.U.I.L.D. Track Location About Meet Pastor Jeremy Meet Our Staff What We Believe How We Are Led I Need Prayer Changing our World Elkhart County Partnerships International Partnerships Harvest Community Church Center UPCOMING EVENTS Life Groups Harvest Kids Harvest Students Harvest Academy Serve Team Restore VBS Bible School Media Current Sermon Series Sunday Messages Stories of Lives Changed

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Harvest Kids

Adult's Name *

First Name

Last Name

Email *

Phone *

(###)

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####

Which service do you plan to attend? *

Child's Name *

First Name

Last Name

Gender *

Child's Birthday *

MM

DD

YYYY

Child's Current Grade *

Nursery

2-3 Year Old

Pre-K

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

Medical Concerns or Allergies? *

What is your relationship to the child?

Child's Name

First Name

Last Name

Gender

Child's Birthday

MM

DD

YYYY

Child's Current Grade

Nursery

2-3 Year Old

Pre-K

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

Medical Concerns or Allergies?

What is your relationship to the child?

Child's Name

First Name

Last Name

Gender

Child's Birthday

MM

DD

YYYY

Child's Current Grade

Nursery

2-3 Year Old

Pre-K

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

Medical Concerns or Allergies?

What is your relationship to this child?

Child's Name

First Name

Last Name

Gender

Child's Birthday

MM

DD

YYYY

Child's Current Grade

Nursery

2-3 Year Old

Pre-K

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

Medical Concerns or Allergies?

What is your relationship to the child?

Thank you!

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