Dave's Club Registration Form
Register only if your child/children are of age 11 to 16
Please provide all the details below. The details you provide will help us to serve your child/children better.
Name - Child 1: *
Your answer
Date of Birth: *
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DD
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YYYY
Name - Child 2:
Your answer
Date of Birth:
MM
/
DD
/
YYYY
Name - Child 3:
Your answer
Date of Birth:
MM
/
DD
/
YYYY
Father's Name:
Your answer
Mother's Name:
Your answer
Address:
Your answer
Contact Information (Phone): *
Your answer
Email id: *
Your answer
Home Church:
Your answer
Any known food allergy:
Your answer
Any known medical condition:
Your answer
Permission to take and use pictures in Media *
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