BRBC Awana 2021-2022 Registration
3231 Briggs Road
Columbus, OH 43204
614-272-7430
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Parent/guardian's full name *
Street address *
City *
State *
Zip *
Cell phone *
Email address *
Photo/video opt-out
Emergency contact #1
Full name *
Relationship to participant *
Phone number *
Emergency contact #2
Full name *
Relationship to participant *
Phone number *
Pick up person(s)
Child can be picked up by *
NOTE: We will still need a signed medical & transportation liability release form for each family on file for each club year. This form will need to be filled out and signed in-person on the first club night.
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