AWANA Child Registration

AWANA CHILD REGISTRATION

2019 FORM

* Indicates required field

Name *

First

Last

Gender *

Male Female

Birthdate *

Age (as of Sept. 5th) *

School Grade (as of Sept. 5th) *

Select One *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Will Your Child Need a Shirt or Vest? *

Phone Number *

Cell Phone Number *

Parent/Guardian Name *

First

Last

Email *

Church you regularly attend, if any: *

Photographs are sometimes taken of children's ministry activities for promotional purposes, which include but are not limited to, in-house presentations, church websites, brochures and newsletters. Children's names and information are never used without specific permission. Please indicate below if you are allowing WABC to use photographs of your child as stated above or not. *

Yes, photographs MAY be taken of my child No, DO NOT take any photographs of my child

If your child has allergies, please list them below: *

Medial Constrictions *

Medications *

Submit