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NCC AWANA Registration Form 2016-2017
Please complete all fields to register for the Newark Community Church AWANA club.

September 14, 2016 thru May 24, 2017
Wednesday nights, 7:00p-8:30p
Check-in between 6:45p-7:00p.

For additional information, email <AWANA@newarkcommunitychurch.org>

Guest of:
Complete this field if you are a guest of a current clubber
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Which Club?
First
Clubber's first name
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Last
Clubber's last name
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Street Address
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City
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ZIP
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Email Address
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Age
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Gender
Grade
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Birthday
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Church
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Home Phone
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Cell Phone
Enter multiple numbers if applicable
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Parent's Name
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Authorized Person 1
Sixth grade and younger children must be signed in and out at their group's room
Your answer
Authorized Person 2
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Authorized Person 3
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Emergency Contact
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Emergency Phone
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Allergies/Special Needs
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Security Policy
Sixth grade and younger children must be signed in and out at their group's room. You must bring your child to their room and sign them in. You cannot just drop them off out front. Children will only be released to a non parent or sibling (12 or older) with pre-arranged authorization. Please identify the Authorized Person(s) to pick up your child in the section above. If this changes please let us know.
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Volunteering
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