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AWANA Registration
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* Indicates required question
Child's Name (nombre de hijo/a):
*
Your answer
Address (direccion):
Your answer
City (ciudad):
Your answer
State (estado):
Your answer
Zip (codigo postal):
Your answer
Birthdate (fecha de nacimiento):
MM
/
DD
/
YYYY
Age as of August 31:
Your answer
Grade as of August 31:
Your answer
Gender
Male
Female
Allergies (alrgias):
Your answer
Siblings (hermanos):
Your answer
Parent/Guardian Names (nombre del padre de familia/guardian)
Your answer
Cell Phone (telefono movi)
Your answer
Emergency Contact Name (other than parent)
(nombre del contacto de emergencia telefono):
Your answer
The following have permission to pick up my child/children (la siguiente persona tiene permiso para recoger a mis hijos):
Your answer
Parent /Guardian Signature (firma de los padres):
Your answer
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