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2023-2024 AWANA Club Registration Form
AWANA Clubs Meeting Wednesday Nights from 6:00 pm- 7:30 pm
Begins Wed. September 6, 2023
Must be Completed and submitted each year
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* Indicates required question
Child's First Name
*
Your answer
Child's Last Name
*
Your answer
Parent/Guardian Name
*
Your answer
Email
Your answer
Mailing Address
*
Your answer
City
*
Choose
Cuero 77954
Goliad 77963
Victoria 77905
Yorktown 78164
Parent/Guardian Phone number
*
Your answer
Child's Birth date
*
MM
/
DD
/
YYYY
Current Grade in School
(Student Must have turned 4 by Sept. 1 in order to enroll in Cubbies)
*
4 year- Pre K (Cubbies)
Kinder- 2nd Grade (Sparks)
3rd Grade- 6th Grade (T&T)
Medical Information
Allergies
*
Yes
No
If yes, please list
Your answer
Food Allergies
*
Yes
No
If yes, please list
Your answer
Any other medical information you feel we need to know?
Your answer
Emergency Contact Information
Please provide 2 people we can contact in case we can't get in touch with you in an emergency.
Name and Phone Number
Your answer
Name and Phone Number
Your answer
Family Information
Do you attend church?
*
Yes
No
If so, where?
Choose
FBC Goliad
Grace Temple
Minnehulla Baptist Church
Faith Family- Victoria
Parkway -Victoria
Other- not listed
May we have permission to photograph your child?
*
Yes
No
Submit
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