AWANA Registration
 
AWANA Registration
Child’s Name:  * 
Address:  * 
City:  * 
Zip Code:  * 
Child’s Birthday:  * 
Child’s Age:  * 
Grade Level (2017 - 18 School Year)  * 
Parent/Guardian Name:  * 
Parent/Guardian Email:  * 
Main Phone #:  * 
Cell Phone #:
May we contact you by text message?  * 
Emergency Contact Name (other than parent):  * 
Emergency Contact Phone #:  * 
Relationship to Child:  * 
Individuals Authorized to pick up Child from Club (Full Name): * 
Medical Conditions/Allergies: * 
Do you regularly attend a local church?  * 
Name of Home Church:
As the legal parent/guardian, I give permission for CiTF to contact my child, by written/electronic communication or telephone to discuss Awana club activities.  * 
As the legal parent/guardian, I give permission for CiTF to use and publish my child’s image in any church publication or promotional material.  * 
How did you find out about Awana at CiTF  * 
Your Email Address  * 
Total $
 
 
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