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AWANA Registration Form
Please complete one form per child. Thank you
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* Indicates required question
AWANA meets Wednesday nights from 6:30-8:00 PM
Child's Name
*
Your answer
Parent/Guardian Name
*
Your answer
Full Address
*
Your answer
Mailing Address (if different from above)
Your answer
Parent's Email Address
*
Your answer
Parent's Cell Phone #
*
Your answer
Age Information
Child's Date of Birth
*
MM
/
DD
/
YYYY
Please indicate child's age/grade
*
Choose
Age 3
Age 4
Age 5 (not in Kindergarten yet)
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Medical Information
Where does your child currently attend school? (if homeschooled, write homeschool)
*
Your answer
Medical or other information we need to know (Please include any food allergies) (if nothing, please write N/A)
*
Your answer
Emergency Contact (other than listed above)
Name and Phone #
*
Your answer
Dismissal Information
Who may pick up your child at the end of each AWANA Day?
*
Your answer
Other Information
Do we have permission to photograph your child?
*
Yes
No
Do we have permission to use your child's photograph for the purpose of promotion?
*
Yes
No
Where did you hear about AWANA at Parkside Baptist? (check all that apply)
*
Church Sign/Banner
Facebook
Flyers
Newspaper
Radio Spot
Word of Mouth
Other:
Required
Has your child/children ever been a part of AWANA before? (at any church)
*
Yes
No
If so, where?
Your answer
Thank you for registering your child for AWANA at Parkside Baptist Church. We are looking forward to a great year!
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