AWANA REGISTRATION
#1 Child's Name
Birthdate
Grade in Fall
Please Select
Preschool
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
#2 Chlid's Name
Birthdate
Grade in Fall
Please Select
Preschool
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
#3 Child's Name
Birthdate
Grade in Fall
Please Select
Preschool
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Address (street, city & zip)
Allergies or Special instructions
Parent/Guardian
Email
Phone - home & cell
Emergency contact & Phone #
I understand that during the year, pictures and video may occasionally be taken. I give permission for my child to be photographed and for those pictures to be used for church purposes.
Parent's Signature
Date
Submit
Should be Empty: