Creekside Awana Registration

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Use this form to register your child for this Fall's program. Please fill out one form for each child.

Email *

Name of child
*

Club

Home address and city
*

Child's date of birth *

YYYY

Grade in 2025-2026 school year

Child's gender
*

Boy

Girl

Names of brothers and/or sisters attending Awana this year

What is the child's father's name (if applicable)?

Father's phone number (if none, type "NA")
*

Father's email address (if none, type "NA") *

What is the child's mother's name (if applicable)?

Mother's phone number (if none, type "NA")
*

Mother's email address (if none, type "NA") *

Viber contact info (if applicable)

Name of person bringing and picking up child:

Please list any allergies, medical conditions, or activity limitations your child has:

Additional comments

A copy of your responses will be emailed to the address you provided.

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