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Divorce Care for Kids on Wednesday, January 23, 2019 @ 6:00 PM

15.00
Please fill out parental information above, and child's information below. Please note that each child will need to be individually registered. 
*Child's First Name:
*Child's Last Name:
*Child's Gender:
*Child's Birthdate:
*Approved Parent/Guardian for Pick-up:
Please list any food allergies, medical conditions, or additional information here: