AWANA Registration 25-26

Parent/Guardian Name

Parent/Guardian Email

This address will receive a confirmation email

Phone

Address

Home Church

Emergency Information

(Emergency contact during club time - someone other than the parents.)

Emergency Contact Name

Emergency Contact Number

Secondary Emergency Contact Name:

Secondary Emergency Contact Number:

Child 1

Child's Name: First, Middle, Last

Child's Nickname

Birthdate

Gender

Male Female

Grade

Pre-K Kindergarten 1st 2nd 3rd 4th 5th 6th

Does this child have any allergies?

Will this child need a book?

Yes No

Will this child need a uniform?

Yes No

Child 2

Child's Name: First, Middle, Last

Child's Nickname

Birthdate

Gender Male Female

Grade Pre-K Kindergarten 1st 2nd 3rd 4th 5th 6th

Does this child have any allergies?

Will this child need a book? Yes No

Will this child need a uniform? Yes No

Child 3

Child's Name: First, Middle, Last

Child's Nickname

Birthdate

Gender Male Female

Grade Pre-K Kindergarten 1st 2nd 3rd 4th 5th 6th

Does this child have any allergies?

Will this child need a book? Yes No

Will this child need a uniform? Yes No Option

Child 4

Child's Name: First, Middle, Last

Child's Nickname

Birthdate

Gender Male Female

Grade Pre-K Kindergarten 1st 2nd 3rd 4th 5th 6th

Does this child have any allergies?

Does this child need a book? Yes No

Does this child need a uniform? Yes No

Payment

The cost is $40.00 per child with a $100.00 max per family. If you need to make payment arrangements just let us know when you arrive. :)

If you choose to pay online there is a transaction fee added.

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

We are glad to be able to provide AWANA for the kids again this year, and look forward to helping your child(ren) learn more about Christ in a safe and fun environment! Please fill out the registration information below and plan to bring your Awana dues to the first night of Awana, September 6th. The cost is $40.00 per child with a $100.00 max per family. Please note, if you choose to pay online a transaction fee will be added. If you need to make payment arrangements just let us know when you arrive. :)

AWANA Registration 25-26

Description

Please Fix the Following