AWANA Registration

AWANA Registration:

* Indicates required field

Clubbers Name *

First

Last

Grade as of this Fall *

Age (as of September 1) *

Gender *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Mom's / Guardian's Name *

Mom's / Guardian's Cell Phone # *

Dad's / Guardian's Name *

Dad's Guardian's Cell Phone # *

Email Addresses *

Primary Emergency Contact, if Parent's cannot be reached: *

Emergency Contact Phone # *

Names of Siblings in AWANA *

Who can pick up? *

Who can NOT pick up: *

Home Church *

How did you hear about AWANA at Community Bible Church? *

Friend / Family AWANA Clubs International Website cbcdemotte.com Touch of Dutch Festival Booth Other

If your chld is NEW, what is their estimated uniform size?

SPARKS - K - 2nd Grad *

Child Small Child Medium Child Larg Child XL Child XXL Child XXXL

TNT - Grades 3rd - 6th *

Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult XL Adult XXL Adult XXXL

Comment *

Allergies or Special Instructions *

Submit

Online Payment for AWANA Registration
is now available!

fees:

The $25.00 registration fee (covers student handbook & uniform if needed, plus prizes and awards) is due by the end of September.