Awana 2021-2022

Awana Online Pre-Registration 2022-2023

Fill out this form in-advance and come in person on Wednesday, September 14th, anytime from 6-8 p.m. to pay dues, pick-up books, etc. PLEASE PLAN ON COMING ON TO THIS NIGHT AS IT HELPS OUR FIRST FEW NIGHTS OF CLUB GO SMOOTHER! THANK YOU! Our First Night of Club will be Wednesday, September 21st. Check in is 6-6:15 pm, check out is 8 p.m. We look forward to seeing you there!
Dues are $25 for 1st & 2nd child, $12.50 for 3rd child & free for 4th child, Books are $12, Vest is $12, T&T Shirt is $16. Dues will not be collected until Registration Night. Scholarships are available.

Have a Middle or High Schooler? Check out our X-Stream Youth Group that also meets on Wednesday nights from 7-8:30!
Contact Information
Parent/Guardian Name *

First Name Last Name
Street Address *
City *
Zip Code *
Phone Number *
Alternate Phone Number *
Email Address - Email is our primary form of communication for announcements & general information , please leave the email that you check most often *
2nd Parent/Guardian Name
2nd Parent/Guardian Phone Number
2nd Parent/Guardian Address (if different from above)
Emergency Information
Emergency Contact Name *
Emergency Contact Phone Number *
Physician Name
Physician Phone Number
Safety Information
Consent *
Relationship to Child(ren) *

Father Mother Guardian
Security: Is there anyone who your child(ren) should NOT be released to? *
May we use pictures or videos of your child(ren)? *

Yes NO
Child 1 Registration
Child's Name *
Child's Gender *

Male Female
Child's Birthday *

Month Day Year
Child's Grade *

Preschool/Cubbies Kindergarten/Sparks 1st Grade/Sparks 2nd Grade/Sparks 3rd Grade/T&T 4th Grade/T&T 5th Grade/T&T
Medical Conditons *
Register Another Child? *

Yes No
Child 2 Registration
Child's Name
Child's Gender

Male Female
Child's Birthday
Child's Grade

Preschool/Cubbies Kindergarten/Sparks 1st Grade/Sparks 2nd Grade/Sparks 3rd Grade/T&T 4th Grade/T&T 5th Grade/T&T
Medical Conditons *
Register Another Child?

Yes No
Child 3 Registration
Child's Name
Child's Gender

Male Female
Child's Birthday

Month Day Year
Child's Grade

Preschool/Cubbies Kindergarten/Sparks 1st Grade/Sparks 2nd Grade/Sparks 3rd Grade/T&T 4th Grade/T&T 5th Grade/T&T
Medical Conditons *
Register Another Child?

Yes No
Child 4 Registration
Child's Name
Child's Gender

Male Female
Child's Birthday

Month Day Year
Child's Grade

Preschool/Cubbies Kindergarten/Sparks 1st Grade/Sparks 2nd Grade/Sparks 3rd Grade/T&T 4th Grade/T&T 5th Grade/T&T
Medical Conditons *
Register Another Child?

Yes No
Child 5 Registration
Child's Name
Child's Gender

Male Female
Child's Birthday

Month Day Year
Child's Grade

Preschool/Cubbies Kindergarten/Sparks 1st Grade/Sparks 2nd Grade/Sparks 3rd Grade/T&T 4th Grade/T&T 5th Grade/T&T
Medical Conditons *
Register Another Child?

Yes No
Child 6 Registration
Child's Name
Child's Gender

Male Female
Child's Birthday

Month Day Year
Child's Grade

Preschool/Cubbies Kindergarten/Sparks 1st Grade/Sparks 2nd Grade/Sparks 3rd Grade/T&T 4th Grade/T&T 5th Grade/T&T
Medical Conditons *
Register Another Child?

Yes No
Should be Empty:

Awana Online Pre-Registration 2022-2023

Dues are $25 for 1st & 2nd child, $12.50 for 3rd child & free for 4th child, Books are $12, Vest is $12, T&T Shirt is $16. Dues will not be collected until Registration Night. Scholarships are available.

Contact Information

Emergency Information

Safety Information

Child 1 Registration

Child 2 Registration

Child 3 Registration

Child 4 Registration

Child 5 Registration

Child 6 Registration