AWANA Registration

Tri-City Baptist Church

Chandler, Arizona
Awana Registration Form
How many Children are you wanting to register? *
Name of Clubber*
Birthdate*

MonthDayYear
Date
Gender*

FemaleMale
Grade (starting in August)*
Club*

Cubbies (3 & 4-year-olds)Sparks (K5-2nd)T&T Girls (3rd-6th grade)T&T Boys (3rd-6th grade)Trek (7th-8th grade
Food Allergies
Additional Medical or Special Information
Name of Clubber*
Birthdate*

MonthDayYear
Date
Gender*

FemaleMale
Grade (starting in August)*
Club*

Cubbies (3 & 4-year-olds)Sparks (K5-2nd)T&T Girls (3rd-6th grade)T&T Boys (3rd-6th grade)Trek (7th-8th grade
Food Allergies
Additional Medical or Special Information
Name of Clubber*
Birthdate*

MonthDayYear
Date
Gender*

FemaleMale
Grade (starting in August)*
Club*

Cubbies (3 & 4-year-olds)Sparks (K5-2nd)T&T Girls (3rd-6th grade)T&T Boys (3rd-6th grade)Trek (7th-8th grade
Food Allergies
Additional Medical or Special Information
Name of Clubber*
Birthdate*

MonthDayYear
Date
Gender*

FemaleMale
Grade (starting in August)*
Club*

Cubbies (3 & 4-year-olds)Sparks (K5-2nd)T&T Girls (3rd-6th grade)T&T Boys (3rd-6th grade)Trek (7th-8th grade
Food Allergies
Additional Medical or Special Information
Name of Clubber*
Birthdate*

MonthDayYear
Date
Gender*

FemaleMale
Grade (starting in August)*
Club*

Cubbies (3 & 4-year-olds)Sparks (K5-2nd)T&T Girls (3rd-6th grade)T&T Boys (3rd-6th grade)Trek (7th-8th grade
Food Allergies
Additional Medical or Special Information
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Will a parent be on campus during AWANA in case of emergency?*

YesNo
Father's Name
Cell Phone
Please enter a valid phone number.
Email
example@example.com
Mother's Name
Cell Phone
Please enter a valid phone number.
Email
example@example.com

My Products

1st Child Registration (includes book)

$35.00

Additional Children Registration

$30.00 Quantity

UniformCubbies vest Sparks vest T&T green polo

$12.00 Quantity

Bag**Cubbies/Sparks Only**

$10.00 Quantity

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Parent or Guardian Signature*

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Tri-City Baptist Church

Awana Registration Form