Awana Contact Information and Permission Authorization
Email address *
Clubber's Last Name *
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Clubber's First Name *
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Parent/Guardian Name(s) *
Your answer
Street Address *
Your answer
City *
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Zip Code *
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Phone Number *
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Email *
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Clubber Birthday *
MM
/
DD
/
YYYY
Clubber Grade *
Hobbies/Activities
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Siblings (names/ages)
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Church Home (Please type "NWBC" if this is your home church) *
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Medical Conditions *
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Brought by (transportation) *
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Invited by
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Individuals authorized to pick up this child *
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Occasionally, we would like to contact your child to see how they are enjoying AWANA and if they need any help in completing their handbooks. We're asking your permission as the legal parent/guardian to contact you and your child by a home visit, written communication, or phone call to discuss club activities. *
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A copy of your responses will be emailed to the address you provided.
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