AWANA - Pre-Registration 2021
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Email *
Child's Name *
Address ( street)
City, Zip *
Parent Phone *
Child's Birth-date *
MM
/
DD
/
YYYY
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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