2012-2013 American Hertiage Girls Pre-Registration

  • After entering all information below, click the Continue button at the bottom of the page to continue.

 

Mom Info     Dad Info
Mom's First Name: 
 
Dad's First Name: 
Mom's Last Name: 
 
Dad's Last Name: 
IBC Attender?: 
 
IBC Attender?: 
E-mail address: 
 
E-mail address: 
Cell phone: 
 
Cell phone: 

Address and Home Phone:

Address:
City:
State:
Zip:
Home Phone:

AHG Programs:

Pathfinders: Age 5 and in Kindergarten
Tenderhearts: Age 6-8 and in Grades 1-3
Explorers: Age 9-11 and in Grades 4-6
Pioneers: Age 12 and in Grades 7-8
Patriots: Age 13 and in Grades 9-12

Child 1 Info  
Name:
Date of Birth:
(MM/DD/YYYY)
AHG Program:
Special Needs :

 

Child 2 Info  
Name:
Date of Birth:
(MM/DD/YYYY)
AHG Program:
Special Needs:

 

Child 3 Info  
Name:
Date of Birth:
(MM/DD/YYYY)
AHG Program:
Special Needs:

 

Child 4 Info  
Name:
Date of Birth:
(MM/DD/YYYY)
AHG Program:
Special Needs:
   
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