AWANA Registration | PPCC

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Pollock Pines
Community Church

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FAITH THAT WORKS!

AWANA
Registration

Child's First Name

Birth Date

Child's Last Name

Current Grade & School

Parent/Guardian & Phone

Mailing Address

Physical Address (if different)

Home Phone

Parent Email

Home Church

Invited by

Medical/Allergies/Special Info (if none, write "None")

EMERGENCY CONTACT (other than parent)

OK to publish photos of activities that include my child

Thanks for registering to our event. See you there!

Contact

6361 Pony Express Trail

PO Box 59

Pollock Pines, CA 95726

530-644-2133

office@pollockchurch.org

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