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Youth Permission & Medical Form 2024-2025
Give
If you have been in the hospital or rehabilitation or are undergoing medical treatments, let the members of our congregation help nourish you back to health. To receive meals, regardless of your eating restrictions, please complete the form below.
First Name
Last Name
Email
Phone Number
Where are you currently staying?
Any dietary restrictions? (you can also list foods that you don't really like and foods that you love as well... we want you to be happy!)
Any prayer requests?
Submit