AWANA Registration 2022-2023

Beginning Wednesdays, 8/17/22 6:00 - 7:30pm | Every Wednesday Night 6pm - 7:30pm
Puggles: Babies - 2yr olds, Cubbies: 3 & 4yr olds, Sparks: K-2nd Grade, T&T: 3rd & 4th Grade
Registration $20 per family
Please fill out this form and click submit.

Name

*

Parent/Guardian

*

Email

*

This address will receive a confirmation email

Cell Phone

*

Address

*

Birth Date

*

Gender

*

Please select one option.

Male Female

Grade

*

Please select one option.

Babies - 2yrs 3 & 4yr olds Kindergarten 1st 2nd 3rd 4th 5th

Allergies, Medical & Special Needs

*

Emergency Contact & Cell Phone

*

Authorized Pickup

*

Are you a member of this church?

*

Please select all that apply.

Yes No

If no, are you a guest of someone?

Do you attend church anywhere?

*

Please select one option.

Yes No

Is yes, where?

May we have permission to photograph your child?

*

Please select all that apply.

Yes No

T-shirt Size

Registration Payment

No Thanks (0) $20 per family ($20)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Beginning Wednesdays, 8/17/22 6:00 - 7:30pm

Every Wednesday Night 6pm - 7:30pm
Puggles: Babies - 2yr olds, Cubbies: 3 & 4yr olds, Sparks: K-2nd Grade, T&T: 3rd & 4th Grade
Registration $20 per family
Please fill out this form and click submit.

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