Online Registration


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AWANA Registration 2010/2011

Cubbies (3-5 year olds)      Sparks (Kindergarten - 2nd Graders)      Truth and Training (3rd -6th Graders)

1st Child   Age

Grade     Birthday  (MM/DD/YR)

Cubbies  Sparks  T-n-T

Medical Conditions/Allergies If Cubbie - potty trained? yes  no

2nd Child   Age

Grade     Birthday  (MM/DD/YR)

Cubbies  Sparks  T-n-T

Medical Conditions/Allergies If Cubbie - potty trained? yes  no

Father's name
Mother's name
Street Address
City State Zip
Home phone Home Church 
Cell phone E-mail address
Emergency contact name Phone
Other Adults authorized to pick up children     
 

Fees required for book and vest/t-shirt
Weekly dues of $.50 will be collected

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