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Revival Nights 2025 Childcare Registration
Childcare will be offered from 6:30 PM-8:30 PM. Ages: 6wks - 4yrs old. Space is limited.
Your name
*
Last name
Email address
*
Phone number
Phone type
Mobile
Home
Work
Other
Secondary Contact Phone Number
*
What days will you be brining your kids to Revival Nights?
*
Check all that apply
Wednesday, August 20th
Thursday, August 21st
Friday, August 22nd
Is your child(ren) allergic to anything they may come in contact with that may cause an acute reaction?
Does your child have a serious medical condition?
Submit
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