In everything we do we want to brag on Jesus, because everybody needs to know who Jesus is.

General Information

Awana Registration
Parent/Guardian First Name (*)
Please let us know your first name.
Parent/Guardian Last Name (*)
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Your Email (*)
Please let us know your email address.
Address (*)
Invalid Input
City, ST, Zip (*) Invalid Input, Invalid Input Invalid Input
Home Phone (*)
Invalid Input: The phone number must be entered in this format 386-555-1212
Cell Phone
Invalid Input: The phone number must be entered in this format 386-555-1212
Work Phone
Invalid Input: The phone number must be entered in this format 386-555-1212
Family Physician Name
Invalid Input
Family Physician Phone
Invalid Input: The phone number must be entered in this format 386-555-1212
Family Dentist Name
Invalid Input
Family Dentist Phone
Invalid Input
Persons (other than parents) authorized to pick up children.
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Comments, concerns or special instructions
Please let us know your message.
Emergency Contact (other than parents)
Invalid Input
Emergency Contact Relationship (*)
Invalid Input
Emergency Contact Phone (*)
The phone number must be entered in the following format: 407-555-1212
Home Church
Invalid Input
How many children are you registering? (*)
Invalid Input: This should just be a number
1st Child's First Name (*)
Invalid Input
1st Child's Last Name (*)
Invalid Input
Gender (*)
Invalid Input: You must choose male or female.
Current Grade
Invalid Input
School Name
Invalid Input
Birth Date (*) Invalid Input Enter the date of birth in this format: MM/DD/YYYY
Check ones that apply
Invalid Input
List any allergies, medications, or special needs
Invalid Input
I am interested in helping out:
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NOTE: All Awana Club leaders and listeners must submit to a background check before check working with children.
Antispam Verification Antispam Verification
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Invalid Input: Please enter the text just as it is seen. This is a security measure to prevent spambots.
Please enter the text just as it is seen. This is a security measure to prevent spambots.

Additional Children

2nd Child's First Name
Invalid Input
2nd Child's Last Name
Invalid Input
Gender
Invalid Input: You must choose male or female.
Current Grade
Invalid Input
School Name
Invalid Input
Birth Date Invalid Input Enter the date of birth in this format: MM/DD/YYYY
Check ones that apply
Invalid Input
List any allergies, medications, or special needs
Invalid Input
3rd Child's First Name
Invalid Input
3rd Child's Last Name
Invalid Input
Gender
Invalid Input: You must choose male or female.
Current Grade
Invalid Input
School Name
Invalid Input
Birth Date Invalid Input Enter the date of birth in this format: MM/DD/YYYY
Check ones that apply
Invalid Input
List any allergies, medications, or special needs
Invalid Input
4th Child's First Name
Invalid Input
4th Child's Last Name
Invalid Input
Gender
Invalid Input: You must choose male or female.
Current Grade
Invalid Input
School Name
Invalid Input
Birth Date Invalid Input Enter the date of birth in this format: MM/DD/YYYY
Check ones that apply
Invalid Input
List any allergies, medications, or special needs
Invalid Input
5th Child's First Name
Invalid Input
5th Child's Last Name
Invalid Input
Gender
Invalid Input: You must choose male or female.
Current Grade
Invalid Input
School Name
Invalid Input
Birth Date Invalid Input Enter the date of birth in this format: MM/DD/YYYY
Check ones that apply
Invalid Input
List any allergies, medications, or special needs
Invalid Input
6th Child's First Name
Invalid Input
6th Child's Last Name
Invalid Input
Gender
Invalid Input: You must choose male or female.
Current Grade
Invalid Input
School Name
Invalid Input
Birth Date Invalid Input Enter the date of birth in this format: MM/DD/YYYY
Check ones that apply
Invalid Input
List any allergies, medications, or special needs
Invalid Input
Please return to the "General Information" tab to submit this registration.

Upcoming Children's Events

Wed Aug 27 @ 6:45PM - 08:15PM
Awana Parent Orientation
Wed Sep 03 @ 6:45PM - 08:15PM
Awana