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COMPLETE YOUR CHECKIN
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COMPLETE YOUR CHECKIN
We need a little more info from you!
COMPLETE YOUR CHECKIN
We need a little more info from you!
COMPLETE YOUR CHECKIN
We need a little more info from you!
COMPLETE YOUR CHECKIN
We need a little more info from you!
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Profile Photo:
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Select Gender
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Select Gender
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Select Gender
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Select Gender
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Select Gender
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Select Gender
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Profile Photo:
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Select Gender
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Select Gender
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Profile Photo:
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Select Gender
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Profile Photo:
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Select Gender
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Select Gender
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Select Gender
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Profile Photo:
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Select Gender
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Select Gender
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Profile Photo:
Upload Photo
Select Gender
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Select Grade
Nursery
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K
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Select Gender
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New text field 15
Select Gender
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Select Grade
Nursery
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Young Adult
How are you?
Click To Select
Fine
Great
Awesome
This is test text
My custom checkbox
Male
Female
Select Gender
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Female
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Nursery
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K
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Select Gender
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Birthday:
you're kinda
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Beach person
Mountain Person
you're kinda
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Beach person
Mountain Person
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op1
op2
you're kinda
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Beach person
Mountain Person
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op1
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dropdown111
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f1
f2
Allergies
Allergies
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Birthday:
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Birthday:
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Birthday:
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Birthday:
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Birthday:
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Profile Photo:
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Select Gender
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Young Adult
How are you?
Click To Select
Fine
Great
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This is test text
My custom checkbox
Male
Female
Select Gender
Male
Female
Select Grade
Nursery
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K
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8th Grade
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Young Adult
How are you?
Click To Select
Fine
Great
Awesome
This is test text
My custom checkbox
Male
Female
Select Grade
Nursery
Pre-School
K
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Young Adult
How are you?
Click To Select
Fine
Great
Awesome
This is test text
My custom checkbox
Male
Female
Select Grade
Nursery
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K
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Birthday:
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Young Adult
How are you?
Click To Select
Fine
Great
Awesome
This is test text
My custom checkbox
Male
Female
Select Grade
Nursery
Pre-School
K
1st Grade
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School
Click To Select
Alexander
Bowdon
Bremen
Carrollton
Central
Heard County
Holy Ground
Homeschool
Mt. Zion
Temple
Villa Rica
UWG
WGTC
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School
Click To Select
Alexander
Bowdon
Bremen
Carrollton
Central
Heard County
Holy Ground
Homeschool
Mt. Zion
Temple
Villa Rica
UWG
WGTC
Other/Not Listed
Birthday:
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Young Adult
Click To Select
Alexander
Bowdon
Bremen
Carrollton
Central
Heard County
Holy Ground
Homeschool
Mt. Zion
Temple
Villa Rica
UWG
WGTC
Other/Not Listed
Select Gender
Male
Female
School
Click To Select
Alexander
Bowdon
Bremen
Carrollton
Central
Heard County
Holy Ground
Homeschool
Mt. Zion
Temple
Villa Rica
UWG
WGTC
Other/Not Listed
Select Grade
Nursery
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K
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Allergies
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Bee
Cillin family (penicillin
amoxicillin etc.)
Dogs
Dust Mites
Latex
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Allergies
All seafood except fish
Apples and shrimp
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N/A
NA
No
Non
None
Nothing
Peanuts
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Snickerdoodle
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N/A
NA
No
Non
None
Nothing
Peanuts
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Allergies
amoxicillin and penicillin
milk
na
nuts
seafood
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pinicllin
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wasps
pollen
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Allergies
-cillian medicines (penticillin
etc.)
coconut
Egg
Facepaint & Walmart brand sunscreen
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Hay and Grass
N/a
nut
Pennicillin
ricotta cheese
sage
seasonal
walnuts
peanuts
strawberries
watermelon
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-cillian medicines (penticillin
etc.)
coconut
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etc.)
coconut
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Facepaint & Walmart brand sunscreen
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N/a
nut
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ricotta cheese
sage
seasonal
walnuts
peanuts
strawberries
watermelon
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Benjamin Logan
Bellefontaine
Indian Lake
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Benjamin Logan
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Benjamin Logan
Bellefontaine
Indian Lake
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sa
saint merry
Universal Design Partners
liberty
fefe
L. P. Savani
Allergies
-
--
?
*NA
All nuts
sesame
soy
egg sorta
Anaphalactic - Nuts
eggs
kiwi
Anaphylactic to seafood
Anaphylaxis to bees
Anaphyllactic to all NUTS
peanuts
tree nuts
animal hair/skin
animals and grass
asthmatic
Bee
Bee Stings
bees
Cashew
pistachio
cashews and Pistacios
Celiac
Dairy
Egg
Nuts
dead memes
Dust mites
Fur
gluten
Gluten Free
fructose intolerant
GRASSSSS
Hay fever
hayfever
Insect Bites
Intolerant to sorbitol (found in fruit juices
sugar-free lollies
apples
pears
stone fruit
chewing gum)
Jelly Beans
Jelly
Animals
Lactose
Lactose intolerant
Latex Powder
Mango
mild bee
mild grass allergy; need to know CARBS in food
Mosquito
n
N/A
NA
nah
Naked Mole Rats
Nil
no
no pork or seafood
non
none
Nope
Not aloud Nurofen
not enny
nothing
Nut Allergy
Nuts (all)
treenuts
citrus seeds
chickpea
Peanut
penacilin
Penasilin
Penasilin + mild unknowns
Penicillin
pollum
Possibly shellfish
rash from sunscreen
Senstivty to Food Chemicals
sesitive skin
Shellfish
avocado
Sunscreen - bannana boat
Unknown
Vegetarian
Walnuts
Birthday:
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K
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Select Gender
Male
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Allergies
-
--
?
*NA
All nuts
sesame
soy
egg sorta
Anaphalactic - Nuts
eggs
kiwi
Anaphylactic to seafood
Anaphylaxis to bees
Anaphyllactic to all NUTS
peanuts
tree nuts
animal hair/skin
animals and grass
asthmatic
Bee
Bee Stings
bees
Cashew
pistachio
cashews and Pistacios
Celiac
Dairy
Egg
Nuts
dead memes
Dust mites
Fur
gluten
Gluten Free
fructose intolerant
GRASSSSS
Hay fever
hayfever
Insect Bites
Intolerant to sorbitol (found in fruit juices
sugar-free lollies
apples
pears
stone fruit
chewing gum)
Jelly Beans
Jelly
Animals
Lactose
Lactose intolerant
Latex Powder
Mango
mild bee
mild grass allergy; need to know CARBS in food
Mosquito
n
N/A
NA
nah
Naked Mole Rats
Nil
no
no pork or seafood
non
none
Nope
Not aloud Nurofen
not enny
nothing
Nut Allergy
Nuts (all)
treenuts
citrus seeds
chickpea
Peanut
penacilin
Penasilin
Penasilin + mild unknowns
Penicillin
pollum
Possibly shellfish
rash from sunscreen
Senstivty to Food Chemicals
sesitive skin
Shellfish
avocado
Sunscreen - bannana boat
Unknown
Vegetarian
Walnuts
Birthday:
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School
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Young Adult
Allergies
-
--
?
*NA
All nuts
sesame
soy
egg sorta
Anaphalactic - Nuts
eggs
kiwi
Anaphylactic to seafood
Anaphylaxis to bees
Anaphyllactic to all NUTS
peanuts
tree nuts
animal hair/skin
animals and grass
asthmatic
Bee
Bee Stings
bees
Cashew
pistachio
cashews and Pistacios
Celiac
Dairy
Egg
Nuts
dead memes
Dust mites
Fur
gluten
Gluten Free
fructose intolerant
GRASSSSS
Hay fever
hayfever
Insect Bites
Intolerant to sorbitol (found in fruit juices
sugar-free lollies
apples
pears
stone fruit
chewing gum)
Jelly Beans
Jelly
Animals
Lactose
Lactose intolerant
Latex Powder
Mango
mild bee
mild grass allergy; need to know CARBS in food
Mosquito
n
N/A
NA
nah
Naked Mole Rats
Nil
no
no pork or seafood
non
none
Nope
Not aloud Nurofen
not enny
nothing
Nut Allergy
Nuts (all)
treenuts
citrus seeds
chickpea
Peanut
penacilin
Penasilin
Penasilin + mild unknowns
Penicillin
pollum
Possibly shellfish
rash from sunscreen
Senstivty to Food Chemicals
sesitive skin
Shellfish
avocado
Sunscreen - bannana boat
Unknown
Vegetarian
Walnuts
Dietary Requirements
How will you be released at the end of the night?
Going home with my parent/guardian
Going home with a friend's parent/guardian (please inform leaders of who)
Make my own way home (with parent's written permission)
Allergies
-
--
?
*NA
All nuts
sesame
soy
egg sorta
Anaphalactic - Nuts
eggs
kiwi
Anaphylactic to seafood
Anaphylaxis to bees
Anaphyllactic to all NUTS
peanuts
tree nuts
animal hair/skin
animals and grass
asthmatic
Bee
Bee Stings
bees
Cashew
pistachio
cashews and Pistacios
Celiac
Dairy
Egg
Nuts
dead memes
Dust mites
Fur
gluten
Gluten Free
fructose intolerant
GRASSSSS
Hay fever
hayfever
Insect Bites
Intolerant to sorbitol (found in fruit juices
sugar-free lollies
apples
pears
stone fruit
chewing gum)
Jelly Beans
Jelly
Animals
Lactose
Lactose intolerant
Latex Powder
Mango
mild bee
mild grass allergy; need to know CARBS in food
Mosquito
n
N/A
NA
nah
Naked Mole Rats
Nil
no
no pork or seafood
non
none
Nope
Not aloud Nurofen
not enny
nothing
Nut Allergy
Nuts (all)
treenuts
citrus seeds
chickpea
Peanut
penacilin
Penasilin
Penasilin + mild unknowns
Penicillin
pollum
Possibly shellfish
rash from sunscreen
Senstivty to Food Chemicals
sesitive skin
Shellfish
avocado
Sunscreen - bannana boat
Unknown
Vegetarian
Walnuts
Birthday:
Favorite Snack
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I am registering for... (choose all that apply for this student)
Sunday School (Pre-K 4-1st Grade)
Sunday School (2nd-5th Grade)
Little Mozarts (Ages 3-5)
Cherub Choir (K-2nd Grade)
Kingdom Kids Ringers (3rd-5th Grade)
Kingdom Kids Singers (3rd-5th Grade)
Nursery
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I am registering for.... (chose all that apply for this student)
Sunday School (Middle School)
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Appalachia Service Project (High School)
Puppets
Revelation Ringers
First Friday Youth Group (Middle School)
First Friday Youth Group (High School)
Rainbow Allyance
Youth Praise Band
Wednesday Walk
Crucifer (High School)
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Be sure you have collected the following info in the Parent Info section above before clicking register.
Parent/Guardian First Name
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Allergies
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Alternative Emergency Contact Details
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diary
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none
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penicillian
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eggs
peanuts
chocolate
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strawberries
pollen
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diary
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diary
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diary
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eggs
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n/a
NA
Nickel adhesive
No
none
Nothing
Nuts but only when eaten
omnisef
sesame
hazelnut
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School
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Campbellsville
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Dietary Restrictions
Allergies
Amoxicillin
bananas
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Gluten
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mosquitos
N/A
NA
No
none
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peanuts
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Andale
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Dary | Nuts | Tree Nuts |
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wasps
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Birthday:
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Is it your first time here?
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Birthday:
Is it your first time here?
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none
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What bag of chips do you like?
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Dupont Middle
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HUME FOGG ACADEMIC
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McGavock
MLK
nashville school of the arts
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1
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no
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sea food
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text
new
new two
asdsadadsa
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test 1
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test 3
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Allergies
-cillian medicines (penticillin
etc.)
coconut
Egg
Facepaint & Walmart brand sunscreen
Gluten
Hay and Grass
N/a
nut
Pennicillin
ricotta cheese
sage
seasonal
walnuts
peanuts
strawberries
watermelon
Allergies
-cillian medicines (penticillin
etc.)
coconut
Egg
Facepaint & Walmart brand sunscreen
Gluten
Hay and Grass
N/a
nut
Pennicillin
ricotta cheese
sage
seasonal
walnuts
peanuts
strawberries
watermelon
Allergies
-cillian medicines (penticillin
etc.)
coconut
Egg
Facepaint & Walmart brand sunscreen
Gluten
Hay and Grass
N/a
nut
Pennicillin
ricotta cheese
sage
seasonal
walnuts
peanuts
strawberries
watermelon
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Allergies
-cillian medicines (penticillin
etc.)
coconut
Egg
Facepaint & Walmart brand sunscreen
Gluten
Hay and Grass
N/a
nut
Pennicillin
ricotta cheese
sage
seasonal
walnuts
peanuts
strawberries
watermelon
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BRCC
none
ur mom
baton rouge magnet high school
sherwood
Allergies
Dogs
Mango
Mangos
n/a
NA
Nickel adhesive
No
none
Nothing
Nuts but only when eaten
omnisef
sesame
hazelnut
Shell fish
Shellfish
Shellfish/fish
Shrimp
Strawberry
Dietary Restrictions
SCHOOL
SCHOOL
SCHOOL
SCHOOL
SCHOOL
SCHOOL
SCHOOL
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Allergies
Amoxicillin
bananas
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Grass
Extensive food allergies
Gluten
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Mold
mosquitos
N/A
NA
No
none
Okra
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peanuts
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oranges
seasonal
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red dye
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School
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aok view
Andover High School
coon rapids high school
Allergies
Amoxicillin
bananas
Cats
Grass
Extensive food allergies
Gluten
Gluten and dairy
Mold
mosquitos
N/A
NA
No
none
Okra
Peanut (nuts)
peanuts
Penicillin
Poinsettias and penicillin
Pollen
Shrimp
Tree nuts
oranges
seasonal
dairy
red dye
What school do you go to?
What school do you go to?
Birthday:
Allergies
-cillian medicines (penticillin
etc.)
coconut
Egg
Facepaint & Walmart brand sunscreen
Gluten
Hay and Grass
N/a
nut
Pennicillin
ricotta cheese
sage
seasonal
walnuts
peanuts
strawberries
watermelon
Instagram
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Favorite Candy:
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Have you been baptized?
YES
NO
NO but I would like more info on that!
School
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College
DeSoto
Festus
Grandview
Hillsboro
Home
None
Other
Potosi
Trade
Christian Brothers College High School
Seckman
Christian Outreach School
Crystal City
Hillsboro/ homeschool
Allergies
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African Am / Blk
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White
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African Am / Blk
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White
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African Am / Blk
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White
Other
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African Am / Blk
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Native Am
White
Other
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African Am / Blk
Hispanic
Asian
Native Am
White
Other
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African Am / Blk
Hispanic
Asian
Native Am
White
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African Am / Blk
Hispanic
Asian
Native Am
White
Other
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Do you like?
Movie
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yes
no
other
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yes
no
other
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Select Gender
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Allergies
Amoxacilen
Bunnies
Cat
Cats
Dogs
maple trees.
Milk
No
None
Nothing
some types of sunscreen
Amoxicillin
Instagram
Allergies
Amoxacilen
Bunnies
Cat
Cats
Dogs
maple trees.
Milk
No
None
Nothing
some types of sunscreen
Amoxicillin
Favorite Fast Food Place
Instagram
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This is test dropdown?
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yes
no
other
School
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sa
saint merry
Universal Design Partners
liberty
fefe
L. P. Savani
School
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sa
saint merry
Universal Design Partners
liberty
fefe
L. P. Savani
School
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sa
saint merry
Universal Design Partners
liberty
fefe
L. P. Savani
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Allergies
Bees
cats dogs elm trees grass weeds
NA
No
none
nut
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What are your other Social Media Handles?
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Birthday:
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Allergies
Cats
na
No
None
None known
Peaches
Allergies
None
Birthday:
School
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sa
saint merry
Universal Design Partners
liberty
fefe
L. P. Savani
Profile Photo:
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Allergies
Amoxacilen
Bunnies
Cat
Cats
Dogs
maple trees.
Milk
No
None
Nothing
some types of sunscreen
Amoxicillin
Dietary Restrictions
Birthday:
School
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Fall Creek Junior High
Fishers Junior High
Hamilton Southeastern Junior High
Homeschool
Mount Vernon Middle School
Noblesville East
Noblesville West
Other
Riverside Junior High
Fishers High School
Hamilton Southeastern High School
Noblesville High School
Mount Vernon High School
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New Zealand European
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Advance Church
Baptist Church
Church @109
Community Bible Church
C3 Church
Equippers Church
Seventh Day Adventist
St Andrew's Anglican Church
St Patrick's Catholic Church
St Paul's Union Church
The Salvation Army
Hobbies, Sports, Interests
Food Limitations
Physical Limitations
Mental Limitations
Social Limitations
Date of last tetanus injection
Fully immunised as per the National Immunisation Schedule
Click To Select
Yes
No
I have supplied health and dietary information and provided details of emergency contacts.
Yes
I consent to my child to being taken out on excursions with Girls' Brigade and using both public and private transport.
Yes
No
If I cannot be readily contacted in the case of an emergency, accident or illness I give permission for the leaders of Girls' Brigade to act in my place with the safety and welfare of my child being of utmost concern.
Yes
I accept that the information I have provided in completing this form will be kept securely on record by GBNZ and will be used for administration purposes. Medical information has been given on the understanding that these details will be kept confid
Yes
Do you have a Prayer Request?
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What is your favorite drink?
What is your favorite candy bar?
What is your favorite kind of food? (chinese, pizza, hamburgers, etc.)
Dietary Restrictions
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What would your theme song be?
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Allergies
Bees
cats dogs elm trees grass weeds
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No
none
nut
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You've Checked In 5 Times! Would you rather fight a bear in the ocean or a shark on land?
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Allergies
Codine
N/a
None
?
.
A
Bees
Benadryl
Bla
Blayden
Boring people
Cat hair
Cats
Coconut
Dairy pork beef eggs sulfa-drugs
Dees nUts
Dirt
Eg tdb
Fish
FLllliti
G
ggg
Gluten and dairy
Gurls
I didn’t have none
Idk
Kd
Lavender and lactose
Lavender citrus cleaning supplies
N
Na
No
Noneeee
Nothing
Ñøńë
Nuts
Paper wasps
Peanuts and treenuts ( not peanut oil)
Penicillin and Celphlysporin
Pinnacillin
Seasonal
Sheh
Some type of medicine
but I don’t know
Stupid People
Sulfa
Sulfur
Tree nuts
Tree Nuts and Peanuts
Vjqgdvvbvdhc
Wheat
Yes
Allergies
Codine
N/a
None
?
.
A
Bees
Benadryl
Bla
Blayden
Boring people
Cat hair
Cats
Coconut
Dairy pork beef eggs sulfa-drugs
Dees nUts
Dirt
Eg tdb
Fish
FLllliti
G
ggg
Gluten and dairy
Gurls
I didn’t have none
Idk
Kd
Lavender and lactose
Lavender citrus cleaning supplies
N
Na
No
Noneeee
Nothing
Ñøńë
Nuts
Paper wasps
Peanuts and treenuts ( not peanut oil)
Penicillin and Celphlysporin
Pinnacillin
Seasonal
Sheh
Some type of medicine
but I don’t know
Stupid People
Sulfa
Sulfur
Tree nuts
Tree Nuts and Peanuts
Vjqgdvvbvdhc
Wheat
Yes
Allergies
Codine
N/a
None
?
.
A
Bees
Benadryl
Bla
Blayden
Boring people
Cat hair
Cats
Coconut
Dairy pork beef eggs sulfa-drugs
Dees nUts
Dirt
Eg tdb
Fish
FLllliti
G
ggg
Gluten and dairy
Gurls
I didn’t have none
Idk
Kd
Lavender and lactose
Lavender citrus cleaning supplies
N
Na
No
Noneeee
Nothing
Ñøńë
Nuts
Paper wasps
Peanuts and treenuts ( not peanut oil)
Penicillin and Celphlysporin
Pinnacillin
Seasonal
Sheh
Some type of medicine
but I don’t know
Stupid People
Sulfa
Sulfur
Tree nuts
Tree Nuts and Peanuts
Vjqgdvvbvdhc
Wheat
Yes
Allergies
Codine
N/a
None
?
.
A
Bees
Benadryl
Bla
Blayden
Boring people
Cat hair
Cats
Coconut
Dairy pork beef eggs sulfa-drugs
Dees nUts
Dirt
Eg tdb
Fish
FLllliti
G
ggg
Gluten and dairy
Gurls
I didn’t have none
Idk
Kd
Lavender and lactose
Lavender citrus cleaning supplies
N
Na
No
Noneeee
Nothing
Ñøńë
Nuts
Paper wasps
Peanuts and treenuts ( not peanut oil)
Penicillin and Celphlysporin
Pinnacillin
Seasonal
Sheh
Some type of medicine
but I don’t know
Stupid People
Sulfa
Sulfur
Tree nuts
Tree Nuts and Peanuts
Vjqgdvvbvdhc
Wheat
Yes
Allergies
Codine
N/a
None
?
.
A
Bees
Benadryl
Bla
Blayden
Boring people
Cat hair
Cats
Coconut
Dairy pork beef eggs sulfa-drugs
Dees nUts
Dirt
Eg tdb
Fish
FLllliti
G
ggg
Gluten and dairy
Gurls
I didn’t have none
Idk
Kd
Lavender and lactose
Lavender citrus cleaning supplies
N
Na
No
Noneeee
Nothing
Ñøńë
Nuts
Paper wasps
Peanuts and treenuts ( not peanut oil)
Penicillin and Celphlysporin
Pinnacillin
Seasonal
Sheh
Some type of medicine
but I don’t know
Stupid People
Sulfa
Sulfur
Tree nuts
Tree Nuts and Peanuts
Vjqgdvvbvdhc
Wheat
Yes
Allergies
Codine
N/a
None
?
.
A
Bees
Benadryl
Bla
Blayden
Boring people
Cat hair
Cats
Coconut
Dairy pork beef eggs sulfa-drugs
Dees nUts
Dirt
Eg tdb
Fish
FLllliti
G
ggg
Gluten and dairy
Gurls
I didn’t have none
Idk
Kd
Lavender and lactose
Lavender citrus cleaning supplies
N
Na
No
Noneeee
Nothing
Ñøńë
Nuts
Paper wasps
Peanuts and treenuts ( not peanut oil)
Penicillin and Celphlysporin
Pinnacillin
Seasonal
Sheh
Some type of medicine
but I don’t know
Stupid People
Sulfa
Sulfur
Tree nuts
Tree Nuts and Peanuts
Vjqgdvvbvdhc
Wheat
Yes
Birthday:
Allergies
-cillian medicines (penticillin
etc.)
coconut
Egg
Facepaint & Walmart brand sunscreen
Gluten
Hay and Grass
N/a
nut
Pennicillin
ricotta cheese
sage
seasonal
walnuts
peanuts
strawberries
watermelon
Birthday:
What is your favorite song?
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