FBC Jacksonville: AWANA

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* Parent's Name(s)
* Address
* City
* State
* Zip Code
* Home Church
Persons (other than parents) authorized to pick up children
* Home Phone
Parent Cell Phone #1
Parent Cell Phone #2
Work Phone
* Parent Email #1
Parent Email #2
* Emergency contact during club time (other than parents)
* Emergency contact phone number
Child(rens) medical doctor
Phone number
Child(rens) dentist
Phone number
* I am interested in helping in Awana:

Please enter information for each child you are registering.

Child #1 Name (First , Middle and Last)
Nickname
Date of birth MM/DD/YYYY
Gender
Grade Fall 2010
School
Need book?
Need uniform?
Uniform size
Allergies/Meds/Special needs

Child #2 Name (First , Middle and Last)
Nickname
Date of birth MM/DD/YYYY
Gender
Grade Fall 2010
School
Need book?
Need uniform?
Uniform size
Allergies/Meds/Special needs

Child #3 Name (First , Middle and Last)
Nickname
Date of birth MM/DD/YYYY
Gender
Grade Fall 2010
School
Need book?
Need uniform?
Uniform size
Allergies/Meds/Special needs

Child #4 Name (First , Middle and Last)
Nickname
Date of birth MM/DD/YYYY
Gender
Grade Fall 2010
School
Need book?
Need uniform?
Uniform size
Allergies/Meds/Special needs

Please be sure to sign your printed registration at your child's first Awana club meeting. We will have it available for you and look forward to seeing your family!
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