Awana Registration Form

AWANA Registration

Fall 2021 - Spring 2022 | Sunday Nights | 5:00PM - 7:00PM
Child 1: Information
Child 1: Name *

First Name Last Name
Child 1: Age *
Child 1: Grade *
Child 1: Birthday *

Month Day Year
Date
Child 1: Food Allergies?
Child 2: Information
Child 2: Name

First Name Last Name
Child 2: Age
Child 2: Grade
Child 2: Birthday

Month Day Year
Date
Child 2: Food Allergies?
Child 3: Information
Child 3: Name

First Name Last Name
Child 3: Age
Child 3: Grade
Child 3: Birthday

Month Day Year
Date
Child 3: Food Allergies?
Child 4: Information
Child 4: Name

First Name Last Name
Child 4: Age
Child 4: Grade
Child 4: Birthday

Month Day Year
Date
Child 4: Food Allergies?
Parent/Guardian Information
Name *

First Name Last Name
Phone Number *
E-mail *
example@example.com
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Name of Home Church
Emergency Information
Emergency Contact's Name *

First Name Last Name
Relationship
Phone Number *
Should be Empty:

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