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AWANA Registration
Register your child for the AWANA Clubs at Taylorville Baptist Church
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* Indicates required question
Email
*
Your email
Parent's Name
*
Your answer
Street Address, City, State, Zip
*
Your answer
Cell Phone
*
Your answer
Name of Child #1
*
Your answer
Birthday of Child #1
*
MM
/
DD
/
YYYY
Current Grade of Child #1
*
Your answer
Medical Conditions of Child #1
*
Your answer
Name of Child #2
Your answer
Birthday of Child #2
MM
/
DD
/
YYYY
Current Grade of Child #2
Your answer
Medical Conditions of Child #2
Your answer
Name of Child #3
Your answer
Birthday of Child #3
MM
/
DD
/
YYYY
Current Grade of Child #3
Your answer
Medical Conditions of Child #3
Your answer
Transportation for all children
*
Your answer
How did you hear about AWANA?
*
Your answer
Individuals authorized to pick up all children
*
Your answer
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