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North Coast Church FUEL 9/10Student Activity Form Activity Dates Sept. 17 2016 Sept. 18 2016 event All-Nighter Fall 2016 STUDENT SNAME print Gender DOB GRADE ADDRESS CITY ZIP School FUEL Group Leader s Name PHONE home Student s Cell Student s email Mother s email Mother s Name print phone h c In case above numbers does not answer please notify NAME PHONE Relationship to Student HEALTH HISTORY CHECK OFF All applicable health issues Allergies-type Allergy-Medications-type Asthma Diabetes...

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