2020-2021 Awana Club
Registration & Medical Release
Please complete one form for each child.
Clubber's Name *
Gender *
Parent's Name *
Street Address *
City, State and Zip *
Phone number *
Email Address *
Birthday *
MM
/
DD
/
YYYY
Grade *
Age *
Has clubber ever attended Awana club at another church? *
If yes, what is the last book or award
Does your child have any physical, emotional, mental or behavioral concerns or limitations that our staff should be award of? (Please explain)
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