AWANA Registration

Please fill out one of these forms for each of your children attending AWANA.

Child's Name
Birthday
Age Group (as of fall 2009)

Mother's name
Father's name
Street address
City
State
Zip
Home phone
Cell phone
Home email address
Home church

In Case of Emergency, Contact
Phone

Pertinent information (include any restrictive pick-up information)
Medical conditions that we need to be aware of
Allergies

How did you hear about our AWANA program?
Brought/Invited by