AWANA Registration 2025-2026
Parent Details:
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
*
example@example.com
Home church
*
Medical insurance company
*
Policy &/or Group #:
Emergency Contact(s) (Name, Cell Phone, relationship to kid(s))
*
My Products
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Dues
Yearly dues
$
20.00
Quantity
1
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9
10
Cubbies vest Medium
(3 & 4 year old by 9/1)
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
Cubbies vest Large (size 6)
$
12.00
Quantity
1
2
3
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5
6
7
8
9
10
Cubbies vest XL (size 8)
$
12.00
Quantity
1
2
3
4
5
6
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8
9
10
Cubbies vest (3 & 4 year old by 9/1)
XXL (size 10)
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
Cubbies Handbook
$
10.00
Quantity
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2
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8
9
10
Cubbies Book Bag
$
5.00
Quantity
1
2
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7
8
9
10
Sparks Medium (size 8) vest
$
12.00
Quantity
1
2
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8
9
10
Sparks Large (size 10) vest
$
12.00
Quantity
1
2
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8
9
10
Sparks XL (size 12) vest
$
12.00
Quantity
1
2
3
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6
7
8
9
10
Sparks XXL (size 14) vest
$
12.00
Quantity
1
2
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8
9
10
1st Spark Handbook
$
10.00
Quantity
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2
3
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8
9
10
2nd Spark Handbook
$
10.00
Quantity
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2
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8
9
10
3rd Spark Handbook
$
10.00
Quantity
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10
Sparks Bag
$
5.00
Quantity
1
2
3
4
5
6
7
8
9
10
T&T Youth Small shirt
Youth Large (14)
$
15.00
Quantity
1
2
3
4
5
6
7
8
9
10
T&T Youth Medium shirt
$
15.00
Quantity
1
2
3
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8
9
10
T&T Youth Large shirt
$
15.00
Quantity
1
2
3
4
5
6
7
8
9
10
T&T Adult Small shirt
Adult Small
$
15.00
Quantity
1
2
3
4
5
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8
9
10
T&T Adult Medium shirt
Adult Medium
$
15.00
Quantity
1
2
3
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5
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8
9
10
T&T (3rd through 6th grade) shirt
Adult Large
$
15.00
Quantity
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2
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8
9
10
T&T Adult XL
$
15.00
Quantity
1
2
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7
8
9
10
T&T Handbook
$
10.00
Quantity
1
2
3
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7
8
9
10
T&T Bag
$
5.00
Quantity
1
2
3
4
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10
Child(ren)
*
Date
*
-
Month
-
Day
Year
Date
I, who by law may do so, authorize the administration of emergency medical treatment to he/she who is subject of this form. I understand all reasonable safety precautions will be taken at all times by Kentwood Heights Baptist Church or its agents. I will not hold Kentwood Heights Baptist Church liable for any accident, injury or disease incurred by the subject of this form. I understand in the event medical intervention is needed every attempt will be made to contact the person(s) above immediately. I will hold Kentwood Heights Baptist Church or its agents harmless due to imprudent behavior from my child. This form will be effective September 2025 to May 2026. I understand by signing this registration form I will pay a yearly fee per child to attend Kentwood Heights Baptist Church AWANA club, as well as the cost of a book and/or uniform. If you have any questions concerning this, please contact Nick Eason, Associate Pastor at 804-932-5370
*
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