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Ankeny Presbyterian Church
GIVE
317 SE Trilein Drive, Ankeny IA 50021
515-964-0264
office@ankenypresbyterian.org
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MARCH 17th @ 10 am - 12:30 pm
FOOD • FUN • GAMES • CRAFTS
FREE!
Register Your Kids Today!
2026 Ankeny Presbyterian - Children's Registration Form
Guardian #1 Name
Cell
Email
Guardian #2 Name (if applicable)
Cell
Email
Street Address
City
Street Address Line 2
State
Postal / Zip code
Church Affiliation
Schools Children Attend
Your Signature
Clear
Participants (Child/Youth)
Child #1 Name
Birthdate
Grade
Cell
Child #2 Name
Birthdate
Grade
Cell
Child #3 Name
Birthdate
Grade
Cell
Important Emergency Information
What should we know about you or your child to ensure the best experience possible at APC? Please note learning or physical disabilities, food or medicine allergies, medical conditions, etc. Attach documents if necessary.
Authorized Pick-Up and Emergency Contact
Authorized Person's Name
Cell
Relationship
SUBMIT
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