AWANA REGISTRATION
PLEASE COMPLETE A FORM FOR EACH CHILD
CHILD'S FIRST NAME: *
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CHILD'S NICKNAME:
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CHILD'S LAST NAME: *
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PARENT'S FIRST NAME: *
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PARENT'S LAST NAME: *
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CHILD'S AGE: *
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CHILD'S DATE OF BIRTH: *
MM
/
DD
/
YYYY
CHILD'S GRADE ('18-'19 school year): *
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PARENT EMAIL: *
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PARENT PHONE NUMBER: *
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ADDRESS: *
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What activities does your child like to do?
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Additional Information (allergies, special needs, any relevant information to best support your child):
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