AWANA Program Registration Form

Wednesday Nights 6:30-7:45 | Please fill out this form and click submit.

Child's Name

*

Parent's Name

*

Phone

*

Alternate Phone

*

Address

*

Home Church

Child's Age

*

Date of Birth

*

School Grade

*

Please select all that apply.

Not in school Kindergarten 1st 2nd 3rd 4th 5th 6th

Email

This address will receive a confirmation email

Did your child participate in another church's AWANA program last year?

*

Please select all that apply.

Yes No

If so, give the name, address, and phone number of the church so we can request a transfer of your child's AWANA records.

Church Name

Church Address

*

Church Phone

*

Does your child have any limitations that would keep him/her from participating in the game time portion of the program?

*

Please select one option.

Yes No

If yes, please explain

Other comments that would be helpful to us as leaders

Description

Wednesday Nights 6:30-7:45

Please fill out this form and click submit.

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