AWANA Registration
2017-2018 School Year
For 2 years old to 6th Grade
(Please fill out one form per child)
AWANA Information Video
Child's First Name:
Your answer
Child's Last Name:
Your answer
Age:
Your answer
Date of Birth:
MM
/
DD
/
YYYY
Gender
Please select age group range they will be entering in the Fall 2017.
Please list parent/guardian
Your answer
Please list parent/guardian
Your answer
Address:
Your answer
City:
Your answer
State:
Your answer
Zip Code:
Your answer
Home Phone Number:
Your answer
Parent/Guardian Cell Phone:
Your answer
Parent/Guardian Email:
Your answer
Special Needs/Allergies:
Please write N/A if this does not apply
Your answer
Siblings attending AWANA:
Your answer
List child you are attending with from VBC (as a friend)
Your answer
Home Church:
Your answer
In Case of Emergency
Please write name and emergency number
Your answer
In Case of Emergency
Please write name and emergency number
Your answer
Please name who is authorized to pick up this child
Your answer
May we have permission to photograph your child?
May we have permission to photograph your child for purpose of promotion?
Would you like to receive reminders via text or email?
If you would like reminders, please give your email or phone number.
Your answer
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