AWANA Registration Form (Fall 2018)
Online registration for AWANA Wednesday Night Program at Corinth Baptist Church.

(Please fill out an individual form for each child being registered)

Email address *
Child's Name (first and last) *
Your answer
Child's Gender *
Child's Birthdate *
MM
/
DD
/
YYYY
Child's Grade (as of September 1, 2018) *
Your answer
Home Address *
Ex. 101 County Line Road, Providence Forge, VA 10101
Your answer
Home Phone Number *
Your answer
What (if any) church do you normally attend? *
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