Awana 2021-22 Registration
Please fill out this form and click submit.
Parent information
First Name
*
Email
*
This address will receive a confirmation email
Phone
*
Address
*
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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
Payment is $30 per child. $75 maximum per family.
*
Payment
$30 per child ($30.00)
$60 for 2 ($60.00)
$75 for 3 or more ($75.00)
$30 per child ($30.00)
$60 for 2 ($60.00)
$75 for 3 or more ($75.00)
Amount
Please note: Children age 3 through preschool are welcome to attend if a parent is a volunteer.
Emergency contact and phone
*
Child(ren) information
Child's name
*
Child's age
Child's gender
Please select one option.
male
femal
Child's grade this fall
Child's clothing size
*
Reminder: 3 & 4 year-olds (preschool students) wear blue both years. Kindergarten, 1st & 2nd graders wear red vests 3 years. 3rd & 4th graders wear green shirts 2 years. Order clothing size accordingly. Kid's EE (5th graders) will get a t-shirt. Please indicate if your child needs a new shirt. No badges will be transferred.
*
Please select one option.
No new shirt needed.
New Blue vest needed
New Red Vest needed
New Green shirt needed
Kid's EE shirt needed
Medical concerns/allergies
Other information we should know
Child #2 Name
Child #2 age
Child #2 gender
Please select one option.
male
female
Child #2 grade this fall
Child #2 clothing size
Reminder: 3 & 4 year-olds (preschool students) wear blue both years. Kindergarten, 1st & 2nd graders wear red vests 3 years. 3rd & 4th graders wear green shirts 2 years. Order clothing size accordingly. Kid's EE (5th graders) will get a t-shirt. Please indicate if your child needs a new shirt. No badges will be transferred.
*
Please select one option.
No new clothing needed.
New blue vest needed
New red vest needed.
New green shirt needed.
Kid's EE shirt
Child #2 medical concerns/allergies
Child #2 other information we should know
Child #3 Name
Child #3 age
Child #3 gender
Please select one option.
male
female
Child #3 grade this fall
Child #3 clothing size
Reminder: 3 & 4 year-olds (preschool students) wear blue both years. Kindergarten, 1st & 2nd graders wear red vests 3 years. 3rd & 4th graders wear green shirts 2 years. Order clothing size accordingly. Kid's EE (5th graders) will get a t-shirt. Please indicate if your child needs a new shirt. No badges will be transferred.
*
Please select one option.
No new shirt needed.
New blue vest needed.
New red vest needed.
New green shirt needed.
EE shirt
Child #3 medical concerns/allergies
Child #3 other information we should know
Payment information
Unnamed Label
*
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing 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
Submit
Description
Please fill out this form and click submit.
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