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AWANA Pre-Registration (Cost is $35 per clubber)
Club:
Cubbies (3 yrs old by Sept. 1st ~ 5 yrs old)
Sparks (K - 2nd grade)
T&T (3rd - 6th grade)
Journey (9th - 12th grade)
Clubber's Name:
Grade:
Gender:
Male
Female
Clubber's Age:
Clubber's Birthdate:
Address 1:
Address 2:
Country:
City:
State:
Zip/Postal Code:
Parent/Guardian Names:
Primary Phone Number:
Email
Church presently attending:
Alternative Contact:
Alternate Contact Name:
Alternative Contact Phone Number:
Medical and Insurance Information:
Physician Name:
Physician Phone Number:
Insurance Carrier:
Policy/Group/ID Number:
Allergy, Medical Conditions:
AWANA pick-up authorization
(Please include you, any other parent/guardian, and friends/family that you would like permission to pick up your clubber.)
The following people are authorized to pick my clubber up from AWANA:
Authorized Person #1:
Relation to Clubber:
Phone Number:
Authorized Person #2:
Relation to Clubber:
Phone Number:
Authorized Person #3:
Relation to Clubber:
Phone Number:
Authorized Person #4:
Relation to Clubber:
Phone Number:
Authorized Person #5:
Relation to Clubber:
Phone Number:
Note: Required release forms to be signed on the clubber's first night of club to complete registration.
Submit
