Awana Registration Form for 2020/2021

Parent/guardian #1 Info

Name

This address will receive a confirmation email

Mobile Phone

Parent/guardian #2 Info (or an additional emergency contact)

Name

This address will receive a confirmation email

Mobile

Address

Complete info for each child who will be attending.

Child #1 Name

Child #1 Birthday

Grade Child #1 Entering Fall 2020

Ages 2 & 3 Puggles (parent must remain in the building) Age 4 Cubbies K Sparkies 1st Sparkies 2nd Sparkies 3rd Truth & Training 4th Truth & Training 5th Truth & Training 6th Truth & Training

School Child #1 Attends

Church Child #1 Attends (if any)

Child #2 Name

Child #2 Birthday

Grade Child #2 Entering Fall 2020 Ages 2 & 3 Puggles (parent must remain in the building) Age 4 Cubbies K Sparkies 1st Sparkies 2nd Sparkies 3rd Truth & Training 4th Truth & Training 5th Truth & Training 6th Truth & Training

School Child #2 Attends

Church Child #2 Attends (if any)

Child #3 Name

Child #3 Birthday

Grade Child #3 Entering Fall 2020 Ages 2 & 3 Puggles (parent must remain in the building) Age 4 Cubbies K Sparkies 1st Sparkies 2nd Sparkies 3rd Truth & Training 4th Truth & Training 5th Truth & Training 6th Truth & Training

School Child #3 Attends

Church Child #3 Attends (if any)

Child #4 Name

Child #4 Birthday

Grade Child #4 Entering Fall 2020 Ages 2 & 3 Puggles (parent must remain in the building) Age 4 Cubbies K Sparkies 1st Sparkies 2nd Sparkies 3rd Truth & Training 4th Truth & Training 5th Truth & Training 6th Truth & Training

School Child #4 Attends

Church Child #4 Attends (if any)

Child #5 Name

Child #5 Birthday

Grade Child #5 Entering Fall 2020 Ages 2 & 3 Puggles (parent must remain in the building) Age 4 Cubbies K Sparkies 1st Sparkies 2nd Sparkies 3rd Truth & Training 4th Truth & Training 5th Truth & Training 6th Truth & Training

School Child #5 Attends

Church Child #5 Attends (if any)

Be sure to complete the required medical release form.You will receive an email after registration is completed with a link to complete the form online.

Payment: $40 per Child

Per Child

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Awana Registration Form for 2020/2021

Description

Please Fix the Following