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

 

Child/Childrenís: Name__________________________Age______

                    Name__________________________Age______

                    Name__________________________Age______

 

Parentís 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/Childrenís: Name__________________________Age______

                    Name__________________________Age______

                    Name__________________________Age______

 

Parentís Name____________________________________________

 

Address__________________________________________________

 

            City____________________  State_______  Zip________      

 

Phone Number___________________________________________

 

Email Address___________________@_______________________

 

Church you attend_______________________________________