AWANA - Pre-Registration 2021
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Email *
Child's Name *
Address ( street)
City, Zip *
Parent Phone *
Child's Birth-date   *
Child's Age *
Parent's Full Name *
Church Now Attending *
Club age group *
Any medical or personal conditions we need to know about to monitor?
Emergency Contacts  - please include name number and relation to child.
Thank you for submitting this form.  You will need to sign a medical waiver on the first night of club attendance...  see you soon!  
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