AWANA Club Additional Child Registration Connection Church AWANA Club Registration AWANA Registration Form Parent Name(Required) First Last Your Child's Name(Required) Child’s First Name Child’s Last Name Registering My Child For: 3 and 4 year-olds – Cubbies Kindergarten to 2nd Grade – Sparks Grades 3 to 5 – T & T Your Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mother's Phone #Father's Phone #Child's Current Grade(Required) Child's Birthdate(Required) Month Day Year Child's Age(Required)Home Church Name School(Required) Email for weekly updates & announcements(Required) Enter Your Email Address Confirm Your Email Address Has your child attended AWANA before?(Required) Yes No If yes, where? Name of church or organization If no, who invited your child? Enter their nameChild lives with(Required) Mother and Father Mother Father Other Emergency Contact Phone #(Required)Emergency Contact Name(Required) First Last Do you need help paying for your child's dues, book or uniform this year?(Required) No, I do not need help paying. Yes, I need to set up payment arrangments. (Please see secretary at check-in table ASAP) Yes, we can’t afford this expense and need a scholarship. Will your child be eating a light meal with us at the church before club starts? Light meal served 5:30-5:45 pm.(Required) Yes No Maybe If yes, any food allergies? Your answerI have read the AWANA Club Guide and have gone over them with my child. When you check this box, you are signing this form.(Required) Agreed NameThis field is for validation purposes and should be left unchanged.