Creekside Youth Registration Form
Use this form to register your child for AWANA in the 2020-2021 school year. Please fill out the form for one child at a time.
* Required
What is the Child's name?
*
Your answer
What Club will the child be a part of?
*
Sparks (Kindergarten-2nd Grade)
T & T (3rd Grade - 5th Grade)
What is the Child's address?
*
Your answer
How old is the Child?
*
Your answer
What is the Child's birthdate?
*
MM
/
DD
/
YYYY
What grade is your child in during the 2020-2021 school year?
*
Please input your answer with the number of the grade only. ie "1" for first grade or "11" for eleventh grade. Please DO NOT input text only answers such as "First" or hybrid answers such as "1st".
Your answer
What gender is your child?
*
Boy
Girl
What School does your child attend?
*
Example: Carlisle Elementary School
Your answer
Has your child been to AWANA prior to this year?
*
Yes
No
Does your child have a handbook?
*
Yes
No
What is the father's name (if applicable)?
*
Your answer
What is the mother's name (if applicable)?
*
Your answer
What is the guardian's name (if applicable)?
Your answer
What is the address of the parent/guardian (if different from the child's)?
Your answer
What is the Father's cell phone number?
*
Provide cell phone number of the father. If this is not applicable type "NA". Example: 515-123-4567
Your answer
What is the Mother's cell phone number?
*
Provide cell phone number of the Mother. If this is not applicable type "NA". Example: 515-123-4567
Your answer
What is the Guardian's cell phone number?
Provide cell phone number of the Guardian. If this is not applicable type "NA". Example: 515-123-4567
Your answer
What is the preferred phone operating system?
*
Select the type of phone the leader will be calling the child on.
Apple/iOS
AndroidOS/Google/Microsoft/Samsung
Which phone number will the leader call for handbook time?
*
Select the number for the phone that the leader should call for the child's designated handbook time.
Choose
Father - Cell
Mother - Cell
Guardian - Cell
What is the Father's email address?
*
If this is not applicable type "NA". Example:
johndoe@gmail.com
Your answer
What is the Mother's email address?
*
If this is not applicable type "NA". Example:
johndoe@gmail.com
Your answer
What is the Guardian's email address?
*
If this is not applicable type "NA". Example:
johndoe@gmail.com
Your answer
Who will bring the child to and pick them up from AWANA when in person meetings resume?
Select the party who will be responsible for picking up and dropping off the child from AWANA.
Father
Mother
Guardian
Other:
Clear selection
Please list any allergies, medical conditions, or activity limitations your child has:
Your answer
Provide additional comments.
Example: Do not give child candy.
Your answer
Submit
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