New Awana Registration

First Name

Middle Name

Last Name

Preferred Name

Birthdate (mm/dd/yyyy)

Grade

Street Address

City

Postal

Parent or Guardian (First & Last Name)

Email Address

Cell #

Okay to Text

Parent or Guardian (First & Last Name)

Email Address

Cell #

Okay to Text

Emergency Contact for Wednesdays (First & Last Name)

Phone #

Child's Home Church

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