Awana Registration

Associated gospel church

* Indicates required field

Name of Child *

First

Last

[object Object]

Name of Child *

First

Last

[object Object]

Birthdate *

GRADE *

K TO 3 4 TO 6

Birthdate *

GRADE *

K TO 3 4 TO 6

Name of Child *

First

Last

Birthdate *

GRADE *

K TO 3 4 TO 6

Name of Child *

First

Last

[object Object]

Birthdate *

GRADE *

K TO 3 4 TO 6

Name of Parent/ Guardian *

Phone Number *

Parents Email *

My Child Is Allowed to Walk Home After Awana *

YES NO

If NO, instructions are as follows: *

Emergency Contact *

First

Last

Relationship to the Child(ren) *

Phone Number *

Submit

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