AMPED Student Ministry Connect Card
Please fill out this form and click submit.
Name
*
Email
*
This address will receive a confirmation email
Cell Phone
Address
*
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AA
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AL
AP
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AS
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BC
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DC
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GA
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YT
Birthday
*
School
*
Grade
*
I attend
*
Please select all that apply.
8:00 Worship Service
9:30 Worship Service
11:00 Worship Service
Not Sure
9:30 Sunday School
Parent Name
Parent Email
Phone Number
Parent Name
Parent Email
Parent Phone Number
I would Like to receive Text Messages about AMPED Students
*
Please select all that apply.
Yes
I'd rather not
Submit
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