CCLW Awana Registrations
Calvary Chapel Living Word
Awana Clubs
Begins September 13, 2017
Wednesday Nights
6:45 pm - 8:30 pm
Ages: 2 years - Elementary
Cost: $60 (payment via paypal below)
Child First Name *
Your answer
Child Last Name *
Your answer
Does your child have an IEP or Special Need to be considered?
Your answer
Child DOB *
MM
/
DD
/
YYYY
Gender *
Have you previously been enrolled in AWANA at another church?
Address
Your answer
Child Grade in Sept 2017 *
City
Your answer
State
Your answer
Zip Code
Your answer
Mother Full Name / Guardian 1 *
Your answer
Mother Cell Phone Number *
Your answer
Father Full Name / Guardian 2
Your answer
Father Cell Phone Number
Your answer
Email *
Your answer
Emergency Contact (Relationship to Child) *
Your answer
Emergency Contact (Full Name) *
Please list someone other than the Guardians listed above.
Your answer
Emergency Contact Cell Phone Number
Your answer
$60 Payment for the uniform, book and awards for this school year.
Once you complete this form, we will send you an invoice for payment.
Submit
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