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Youth Basketball League
LITTLE MISS BELLE RIVE PAGEANT ENTRY FORM
*
Indicates required field
Child's Name
*
First
Last
Parent/Guardian Name
*
First
Last
Phone Number (will be used for texting important pageant info)
*
Email
*
Address
*
Street Address, City, State
Birth Date
*
Age
*
May we have permission to photograph your child?
*
Yes
No
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For questions please call our church office at 618-756-2252.
WE WANT TO
REACH OUR
C O M M U N I T Y
FOR JESUS
