AWANA 2017-2018 Registration
Use this form to register your child for Awana at Bethany Baptist Church
Date *
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Child's Name *
Your answer
Grade *
Your answer
Birthday *
MM
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DD
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YYYY
Address *
Your answer
Home Phone
Your answer
Cell Phone *
Your answer
Parents or Legal Guardians
Name *
Your answer
Phone *
Your answer
Email *
Your answer
Name
Your answer
Phone
Your answer
Email
Your answer
Emergency Contact (if parent or guardian is unable to be reached)
Name *
Your answer
Phone *
Your answer
Name
Your answer
Phone
Your answer
Other info
Please list here any allergies your child may have
Your answer
Who may pick up your child? *
Your answer
Permission Granted for helping during potty breaks (younger children only) *
May we have permission to photograph your child? *
May we have permission to use your child's photograph for promotion? *
Please sign you name below *
Your answer
Date *
MM
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DD
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YYYY
Submit
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