AWANA Registration Form 2025-2026

AWANA Registration Form 2025-2026

Winfield Bible Chapel
Child's Name

First NameLast Name
Birth date

MonthDayYear
Date
Age
Grade
Gender

MaleFemale
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Allergies / Restrictions
Parent's Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Do you currently attend a church?

YesNo
Who will be dropping off / picking up your child?

First NameLast Name
T-Shirt size:
Which AWANA club will your child be attending?
(Optional) I hereby certify that my child blank attends church regularly and should receive Church Attendance Awards (for Cubbies, Sparks, and T&T).
Parent Signature ______________________________________________________
In Case of Emergency Call (Other than parents)

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship to child
I, the undersigned, request that my child be permitted to participate in the Winfield Bible Chapel AWANA Ministry. I agree to hold harmless Winfield Bible Chapel or any of their agents in the event of accident, illness, injury, or death, which may occur
during any and all activity (AWANA sponsored activities). I also grant permission to photograph/video my child for use in representing Winfield Bible Chapel and/or AWANA, such as (but not limited to) our bulletin board, Facebook page, & website).
Parent Signature ______________________________________________________
Questions? Please contact Pastor Jim Brunson at wbcjimb@gmail.com
Should be Empty: