Awana Registration Form 2022-2023

Awana 2022-2023 Registration Form

*PLEASE REGISTER EACH CHILD INDIVIDUALLY
*Online Registration will be closed on August 24th

The first night of Awana will be on September 7th in Person! The doors each week will open at 6:30pm and club will begin at 6:45pm. We ask that new families come early so they have a chance to get checked in and settled before club starts.
Parent's Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Cell Phone Number *

Area Code Phone Number
Home Phone Number

Area Code Phone Number
E-mail *
Current Church Affiliation *

Alternative Contact Information

Please make sure contact information is different than parent information above. This will also be the secondary emergency contact.
Alternative Contact Name *

First Name Last Name
Alternative Contact Phone Number *

Area Code Phone Number
Doctor's Name *

First Name Last Name
Doctor's Number *

Area Code Phone Number
Insurance Company *

Child's Information
Child's Name *

First Name Last Name
Allergies
Medications
Are there any medications your child will be bringing to club each week?
Child's Age as of Aug. 1st *
Child's Birthday *

Month Day Year
Date
Child's Gender *

Male Female
Child's Grade in Fall *
Which Club will your child be participating in? *

Cubbies (3-5 years old) Sparks ( K-2 Grade) T&T Girls (3-6 Grade) T&T Boys (3-6 Grade)
Signature *

Clear

Awana 2022-2023 Registration Form