AWANA 2026-2027 Registration Form

AWANA 2026-2027 Registration Form

Online event registration based on the AWANA registration PDF. Please complete the child, parent/guardian, church affiliation, pickup/emergency, medical/special needs, permissions, and signature fields.
Children Information
Child 1 Name

First NameLast Name
Child 1 Age
Child 1 Grade
Child 1 Birthdate

MonthDayYear
Date
Child 2 Name

First NameLast Name
Child 2 Age
Child 2 Grade
Child 2 Birthdate

MonthDayYear
Date
Child 3 Name

First NameLast Name
Child 3 Age
Child 3 Grade
Child 3 Birthdate

MonthDayYear
Date
Child 4 Name

First NameLast Name
Child 4 Age
Child 4 Grade
Child 4 Birthdate

MonthDayYear
Date
Child 5 Name

First NameLast Name
Child 5 Age
Child 5 Grade
Child 5 Birthdate

MonthDayYear
Date
Parent / Guardian Information
Parent / Guardian Name

First NameLast Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
City
Zip
Preferred Phone #
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Phone #
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Church Affiliation
Member of The Country Church?
If not, which church do you attend?
Pickup / Emergency Contact
Besides you, who may pick up your child?
Emergency Contact Name

First NameMiddle NameLast Name
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Medical / Special Needs
Severe allergies or medical conditions
Learning disabilities or special needs
Permissions
Photo/Video Release for Minor
Correspondence Release for Minor
Signatures
Parent/Legal Guardian Signature (Attendance Permission)
Parent/Guardian Signature (Medical/Special Needs Acknowledgment)
Date

MonthDayYear
Date
Should be Empty:

AWANA 2026-2027 Registration Form

Children Information

Parent / Guardian Information

Church Affiliation

Pickup / Emergency Contact

Medical / Special Needs

Permissions

Signatures