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AWANA - Pre-Registration 2021
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* Required
Email
*
Your email
Child's Name
*
Your answer
Address ( street)
Your answer
City, Zip
*
Your answer
Parent Phone
*
Your answer
Child's Birth-date
*
MM
/
DD
/
YYYY
Child's Age
*
Your answer
Parent's Full Name
*
Your answer
Church Now Attending
*
Your answer
Club age group
*
Puggles ages 2's and 3's
Cubbies 3 and 4 years old - must be 3 by Sept 1st.
Sparks Kindergarten
Sparks 1st grade
Sparks 2nd Grade
T and T - 3rd through 6th grade
Any medical or personal conditions we need to know about to monitor?
Your answer
Emergency Contacts - please include name number and relation to child.
Your answer
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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