HALLELUJAH NIGHT REGISTRATION 20___
(Form only required for Children ages 12 & under)

Child/Children’s: Name__________________________Age______

                    Name__________________________Age______

                    Name__________________________Age______

Parent’s Name____________________________________________

Address__________________________________________________

            City____________________  State_______  Zip________      

Phone Number___________________________________________
 

Email Address___________________@_______________________

Church you attend_______________________________________

      --------------------------------------------------------------------

HALLELUJAH NIGHT REGISTRATION 20___
(Form only required for Children ages 12 & under)

Child/Children’s: Name__________________________Age______

                    Name__________________________Age______

                    Name__________________________Age______

Parent’s Name____________________________________________

Address__________________________________________________

            City____________________  State_______  Zip________      

Phone Number___________________________________________

Email Address___________________@_______________________

Church you attend_______________________________________