AWANA Registration 2026-2027
Parent Details:
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
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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( X )
Dues
Yearly dues
$20.00
$
20.00
Quantity
1
2
3
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5
6
7
8
9
10
Cubbies vest Medium
(3 & 4 year old by 9/1)
$12.00
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
Cubbies vest Large (size 6)
$12.00
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
Cubbies vest XL (size 8)
$12.00
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
Cubbies vest XXL (size 10)
$12.00
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
Cubbies Handbook
$10.00
$
10.00
Quantity
1
2
3
4
5
6
7
8
9
10
Cubbies Book Bag
$5.00
$
5.00
Quantity
1
2
3
4
5
6
7
8
9
10
Sparks Medium (size 8) vest
$12.00
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
Sparks Large (size 10) vest
$12.00
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
Sparks XL (size 12) vest
$12.00
$
12.00
Quantity
1
2
3
4
5
6
7
8
9
10
Sparks XXL (size 14) vest
$12.00
$
12.00
Quantity
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2
3
4
5
6
7
8
9
10
1st Spark Handbook
$10.00
$
10.00
Quantity
1
2
3
4
5
6
7
8
9
10
2nd Spark Handbook
$10.00
$
10.00
Quantity
1
2
3
4
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6
7
8
9
10
3rd Spark Handbook
$10.00
$
10.00
Quantity
1
2
3
4
5
6
7
8
9
10
Sparks Bag
$5.00
$
5.00
Quantity
1
2
3
4
5
6
7
8
9
10
T&T Youth Small shirt
Youth Large (14)
$15.00
$
15.00
Quantity
1
2
3
4
5
6
7
8
9
10
T&T Youth Medium shirt
$15.00
$
15.00
Quantity
1
2
3
4
5
6
7
8
9
10
T&T Youth Large shirt
$15.00
$
15.00
Quantity
1
2
3
4
5
6
7
8
9
10
T&T Adult Small shirt
$15.00
$
15.00
Quantity
1
2
3
4
5
6
7
8
9
10
T&T Adult Medium shirt
$15.00
$
15.00
Quantity
1
2
3
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5
6
7
8
9
10
T&T Adult Large shirt
$15.00
$
15.00
Quantity
1
2
3
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5
6
7
8
9
10
T&T Adult XL
$15.00
$
15.00
Quantity
1
2
3
4
5
6
7
8
9
10
T&T Handbook
$10.00
$
10.00
Quantity
1
2
3
4
5
6
7
8
9
10
T&T Bag
$5.00
$
5.00
Quantity
1
2
3
4
5
6
7
8
9
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 2026 to May 2027. 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 the church office at 804-932-5370
*
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