Ankeny Baptist Church AWANA Registration 2018-19
Please complete the registration process for each child who will be attending our AWANA ministry this year. Please note that our AWANA program is for all children from Kindergarten through 6th grade. Thank you.
First Name *
Please type the first name of the child you are registering:
Your answer
Last Name *
Please type the last name of the child you are registering:
Your answer
Parent/Guardian *
Please type the first and last name of the child's parent(s) or guardian(s):
Your answer
Address *
Please list your address:
Your answer
Home Phone *
Please provide the home phone number for the child's parent or guardian:
Your answer
Work or Cell Phone
Please provide the work or cell phone number for the child's parent or guardian:
Your answer
Email Address
Please provide an email address for the child's parent or guardian:
Your answer
Allergies/Medical Information
Please indicate if the child has any allergies or other medical information that staff should be aware of:
Your answer
Emergency Contact Name
Please provide the name of an emergency contact if the parent or guardian can not be reached:
Your answer
Emergency Contact Phone Number
Please provide the phone number for the emergency contact:
Your answer
Birth Date (mm/dd/yyyy) *
Please enter the child's birth date in month/day/year format:
Your answer
Grade *
Please indicate the child's grade for the 2018-19 school year. The Ankeny Baptist AWANA program is offered for all children from Kindergarten through 6th grade.
Required
Brought By
Please indicate who will be dropping off and picking up the child, and contact information if it is different than noted above:
Your answer
Home Church
Please indicate your home church; or if you do not regularly attend a church, please indicate if you would be open to learning more about Ankeny Baptist Church:
Your answer
Additional Information
Please indicate any additional information that will be helpful to AWANA staff:
Your answer
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