Lighthouse Missionary Church
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    Health form

    Health history

    Please complete the following. The information provided will be used at all youth related activities in conjunction with Lighthouse Missionary Church, including: youth group, quiz meets, camps, retreats, and other outings.
    Please list any allergies your child may have: including foods, insects, medications, seasonal, etc. Include a description of the reaction and how it is managed. If your child has no known allergies, please write NKA. Thank you!
    Does your child have any health concerns, disabilities, injuries? Such as Asthma, Anxiety, Depression, Diabetes, Headaches, Seizures, Menstrual cramps, Fainting, Frequent Colds, etc. If your child has no health concerns please write none that we know of.
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Address: 7824 Rogers Rd., East Jordan, MI 49727

Office phone (231) 536-2128

Office email: [email protected]

  • Home
    • Contact Us
  • Live Stream
  • Movie Night
  • About us
    • Board Members & Staff
    • History
    • Missions
  • Lynn's Devotional
  • WHAT'S HAPPENING
    • LMC Calendar
    • Life House Calendar
    • Children's Church Schedules
    • LMC Newsletter
    • Prayer page
  • MORE
    • Volunteer Survey
    • Nomination Survey
    • Health Form
    • Local Conference
    • Scholarship Applications
    • Prayer Chapel
  • Soul Care