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2022 AWANA Enrollment Form
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* Indicates required question
Email address
*
Your answer
Child's Full Name
*
Your answer
Name Called By
*
Your answer
Age
*
Your answer
Gender
*
Female
Male
Parent's Name(s)
*
Your answer
Address
*
Your answer
City, State, Zip
*
Your answer
Work #
*
Your answer
Home #
*
Your answer
Dad's Cell #
*
Your answer
Mom's Cell #
*
Your answer
Birthday
*
MM
/
DD
/
YYYY
Diet Restrictions (If none please leave blank.)
Your answer
Special Notes or Concerns (If none please leave blank.)
Your answer
I give permission for my child's picture to appear on the church website (no names will be given)
*
Yes
No
Do you attend church?
*
Yes
No
If yes, give name of church
*
Your answer
Parent or Guardian Signature
*
Your answer
Grade
*
2 years old
Pre-K (3-5 years old)
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
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