Awana Registration

Register your child for Awana by filling out the information below:

Child's First Name

Child's Last Name

Child's Date of Birth

Child's Gender

Male

Female

Grade Level for 2017/18 School Year

Parent's First Name

Parent's Last Name

Your contact info:

Email Address

Phone Number

What is the best way to reach you?

Phone

Snail Mail

Emergency Contact: Name, Relationship and Phone #.

Please enter your full address:

Street Address

City

State

Zip Code

Medical / Allergy / Dietary Info

Which church are you attending, if any?

Additional Information

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