AWANA Registration 2026/27
Wednesdays, 6-7:30 pm, beginning September 9, 2026 | Please fill out this form and click submit. Thank you!
Child's Name
*
Grade (this fall)
*
Please select all that apply.
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Birth Date
*
Age
*
Gender
*
Please select all that apply.
Male
Female
Please list any allergy/medication/special needs information we should be aware of (or write N/A if none).
*
Address
*
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Phone
*
Parents Names
*
Email
*
This address will receive a confirmation email
Mother's Cell Phone
Father's Cell Phone
Emergency Contact Name & Cell Phone
*
Please list all persons (other than parents) who are authorized to pick up your child.
*
Submit
Description
Wednesdays, 6-7:30 pm, beginning September 9, 2026
Please fill out this form and click submit. Thank you!
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