SPVC Youth 
Please fill out the following information so that we can gather the most current information about our youth so that we can plan events appropriately and move forward with rebuilding our Youth Group! ~Rev. Streeper
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(Student) First Name *
(Student) Last Name *
Birthday *
MM
/
DD
/
YYYY
Grade Level (2023-2024 Academic Year) *
Name of School Attending *
Parent/Guardian Name *
Parent/Guardian Cell Phone *
Parent/Guardian Email *
Student Cell Phone *
Student Email *
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