Awana Registration 2017 - 2018
Registration Form for Northgate Church's Awana Program which runs from Sept 20, 2017 to May 9, 2018
Child's Last Name *
Your answer
Child's First Name *
Your answer
Gender *
Birthdate *
MM
/
DD
/
YYYY
Age *
As of September 20, 2017
Your answer
Grade *
Allergies, Medical Concerns, Special Needs
Your answer
Parent / Guardian --- Last Name *
Your answer
Parent / Guardian --- First Name *
Your answer
Phone Number(s) *
Your answer
Email *
Your answer
Mailing Address *
Your answer
Other Parent / Guardian or Emergency Contact --- Last Name *
Your answer
Other Parent / Guardian or Emergency Contact --- First Name *
Your answer
Emergency Contact Phone Number(s) *
Your answer
By clicking the box below, I, the parent / guardian of the above named child, give permission for them to participate in Awana activities at Northgate Church. *
Required
Permission to Photograph *
I give permission for my child to be photographed and videotaped, and for these images to be used during the Awana program and for future promotional material.
Required
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