Registration Form

Parent | Legal Guardian

First Name

Last Name

Phone Number (phone and sms capable preferred)

(###)

###

####

Best Email Address

Child's Name

First Name

Last Name

Grade

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact

First Name

Last Name

Relation To Child

Emergency Phone Number

(###)

###

####

Activity

Which activity would you like to register for? (Select all that apply)

AWANA Sparks

AWANA Truth & Training

Other (please specify)

Other Event:

2nd Emergency Contact

First Name

Last Name

Phone Number

(###)

###

####

Relation To Child

List Any Known Allergies/Physical Problems

Date of Signature

YYYY

Parent | Guardian Signature

First Name

Last Name