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Grace Baptist Church

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Independent Fundamental KJV

Child's First Name

Your Email Address

Child's Last Name

Your Phone Number

Your Address

Age Group

Is This a Copy of a Previous Registration? *

Yes

No

Please List Any Known Allergies

I Attest That I am the Legal Guardian of the Child * Required

Yes

Further Inquiries

Your Registration Has Been Submitted, Thank You.

101 Donation Road, Greenville, PA 16125
gbcgreenvillepa@gmail.com | 724-588-5520

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