Awana Registration Form 2024-2025

Awana 2024-2025 Registration Form

*PLEASE REGISTER EACH CHILD INDIVIDUALLY
* Registration will be closed on September 18th

The first night of Awana will be on September 4th 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 NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Cell Phone Number*

Area CodePhone Number
Home Phone Number

Area CodePhone 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 NameLast Name
Alternative Contact Phone Number*

Area CodePhone Number
Doctor's Name*

First NameLast Name
Doctor's Number*

Area CodePhone Number
Insurance Company*

Child's Information
Child's Name*

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

MonthDayYear
Date
Child's Gender*

MaleFemale
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 2024-2025 Registration Form