Form

AWANA REGISTRATION
#1 Child's Name
Birthdate
Grade in Fall
#2 Chlid's Name
Birthdate
Grade in Fall
#3 Child's Name
Birthdate
Grade in Fall
Address (street, city & zip)
Allergies or Special instructions
Parent/Guardian
Email
Phone - home & cell
Emergency contact & Phone #
I understand that during the year, pictures and video may occasionally be taken. I give permission for my child to be photographed and for those pictures to be used for church purposes.
Parent's Signature
Date
Should be Empty:

AWANA REGISTRATION