Nursery (Awana Workers only) Toddler(Puggles) Pre-K (Cubbies) K-2nd (Sparks) 3rd-4th (T&T) 5th-6th (T&T) 7th & 8th (Trek)   Child Information Child's First Name:  * Last Name:  * Address:  * Address 2: City:  * State:  * Zip Code:  * Home Phone:  *   Parent/Guardian Information Parent/Guardian Name:  * Parent/Guardian Work Phone:  * Parent/Guardian Cell Phone:  * Parent/Guardian Email (if applicable): 2nd Parent's Name: 2nd Parent's Work Phone: 2nd Parent's Email (if applicable):   Emergency Contact Name:  * Relationship: Phone:  *   Pick-up Authorization (not required for Trek) Please complete the section below regarding those authorized to pickup your child in addtion to the parent(s) or guardain listed above. Make sure to include anyone who drives your child as a part of a car pool and your emergency contact listed above. Pick-Up #1 Phone Number #1 Email #1 Special Instructions #1 Pick-Up #2 Phone Number #2 Email #2 Special Instructions #2 Pick-up #3 Phone Number #3 Email #3 Special Instructins #3   Health Information Please list any allergies or medical conditions of your child. If None please type N/A.  * Doctor's Name:  * Doctor's Phone:  *   General Information Child's Birthdate:  * Grade as of 09/07/2011:  * Name of Home Church:   Want to help? Just list for us your skills right here --> Security code:   * Do not enter anything in this field: