Auburn Church

Guest Registration Form
All guests, please fill out Section 1
1. CHILD'S FIRST NAME ::
CHILD'S LAST NAME ::
DATE OF BIRTH ::
AGE ::	MALE FEMALE
PERSON BRINGING CHILD / RELATIONSHIP ::
ALLERGIES / HEALTH CONCERNS ::
HOME PHONE ::

If you wish to enroll your child, please fill out Section 2
2. MOM'S AND DAD'S NAME(S) ::
PARENT'S MARITAL STATUS ::	MARRIED SINGLE
STREET ::
CITY ::
STATE ::
ZIP ::
E-MAIL ::