WHAT YESHUA CAN DO

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Student Name
Grade?
Guardian's Name
Phone Number
Alternative Phone Number
Email
Does your child have any allergies we will need to know of?
Does your child take any medications that will need to be taken?
I am the Guardian of child listed above and allow said child to attend the 2020 Youth Lock In. I understand that What Yeshua Can Do and Impact Ministries, and any other affiliations, are not responsible for any lost, stolen, and/or injury during the duration of this trip.
- I agree.
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