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June 21-26, 2021
UNION UNIVERSITY ~ JACKSON, TN

* Indicates required field

Student Name *

First

Last

Parent Name *

First

Last

Parent Name *

First

Last

Choose Centrifuge or Mfuge *

Parent's Phone Number *

Email - Parent 1 *

Email - Parent 2 *

Student Email (add only if your child checks email regularly) *

Home Church (if applicable) *

Questions? *

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