AWANA Registration
Sundays @ 5:30 pm (During the School Year)
Child Name
*
First Name
Middle Name
Last Name
Suffix
Birthday
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Age
*
What grade is your child in for the 2026-2027 school year?
*
Please Select
K3
K4
K5
1st
2nd
3rd
4th
5th
6th
List any allergies or important medical information (Write "none" if nothing to add)
*
Parent/Guardian Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
E-mail
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
In the space below, list any other people (and their phone number) you authorize to pickup your child at the end of AWANA.
Has your child been in AWANA before?
*
Yes
No
If "Yes", what was the last book/section they completed?
If "Yes", please list any/all awards your child has previously received.
Does your child have an AWANA bag & vest?
*
Yes
No
If "No", what size vest do they need?
Comment (if you need to add more clubbers, you may include all pertinent information pertaining to the child below, or submit a separate form)
Submit
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