Awana

2018 Awana Registration

 

Required fields

Parent/Guardian Information

First Name
Last Name
Address
City
State
    Zip  
Email
Primary Telephone
Alternate Telephone
Emergency Contact 1
Emergency Telephone 1
Emergency Contact 2
Emergency Telephone 2
Authorized Pick Up
 
Authorized Adult 1
Parent/Guardian named above
Authorized Adult 2
Authorized Adult 3
Authorized Adult 4

 


Awana Kids

INSTRUCTIONS:

Register up to six (6) children at once by completing the child(ren) information sections below. After the first child, to submit additional children check the appropriate box for adding child 2, 3, 4, 5 or 6 and provide the required information for each.

Child(ren) Information

First Name
Last Name
Gender
Birth Date
/ /
Grade Completed
Medical Notes
IBC Member
No Church
Other Church
IBC Referral
Place With Name

Add Child 2

First Name
Last Name
Gender
Birth Date
/ /
Grade Completed
Medical Notes
IBC Member
No Church
Other Church
IBC Referral
Place With Name

Add Child 3

First Name
Last Name
Gender
Birth Date
/ /
Grade Completed
Medical Notes
IBC Member
No Church
Other Church
IBC Referral
Place With Name

Add Child 4

First Name
Last Name
Gender
Birth Date
/ /
Grade Completed
Medical Notes
IBC Member
No Church
Other Church
IBC Referral
Place With Name

Add Child 5

First Name
Last Name
Gender
Birth Date
/ /
Grade Completed
Medical Notes
IBC Member
No Church
Other Church
IBC Referral
Place With Name

Add Child 6

First Name
Last Name
Gender
Birth Date
/ /
Grade Completed
Medical Notes
IBC Member
No Church
Other Church
IBC Referral
Place With Name