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AWANA Sign Up
Wednesday nights from 6:00- 7:30 p.m.
Ages 3yrs - 6th Grade
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* Indicates required question
Email
*
Your email
Attendee's First Name
*
Your answer
Attendee's Last Name
*
Your answer
Parent's First / Last Name
*
Your answer
Address
*
Your answer
City
*
Your answer
State
*
Illinois
Indiana
Phone Number
*
Your answer
Attendee's Age
*
Your answer
Attendee's Birthday
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MM
/
DD
/
YYYY
Grade
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Choose
Pre-K
Kindergarten
1st
2nd
3rd
4th
5th
6th
Please list Medical Information and Allergies, If none please put N/A
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Your answer
Will your Child be riding the bus?
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Yes
No
May we have permission to photograph your child?
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Yes
No
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