Awana Pre-Registration

If preferred, you can fill out a paper form in person prior to dropping your child off.

If you are a human and are seeing this field, please leave it blank.

Child's First Name

Child's Last Name

Date of Birth

Parent or Guardian #1's Full Name

Parent or Guardian #1's Relationship to Child

Parent or Guardian #1's Cell Phone Number

Parent or Guardian #2's Full Name

Parent or Guardian #2's Relationship to Child

Parent or Guardian #2's Cell Phone Number

Primary Email Address

Address

If not, what church do you regularly attend?

Emergency Contact Name and Relationship to Child

Emergency Contact Phone #

#1 Name of authorized adult to pick up child and their relationship to child

#2 Name of authorized adult to pick up child and their relationship

#3 Name of authorized adult to pick up child and their relationship