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Saturday, May 19th, 2012

Awana Registration Form

Required Fields*

Child's Name:*

Parent/Guardian:*

Address:*

Address Line 2:

City:*

State: *

Zip Code:*

Home Phone:*

Mobile Phone:

Work Phone:

EMERGENCY CONTACT

Contact 1*

Name:

Phone:

Contact 2

Name:

Phone:

CHILD'S INFORMATION

Birthdate:

/	/
mm	dd	yyyy

Age:*

Gender

Male Female

Last Grade Completed:*

Do you attend church?

Yes No If so, where?

Do you attend
Sunday School?

Yes No If so, where?

Please list all allergies:

Who is authorized to pick up your child?

Name:

Phone:

Name:

Phone:

Does First Baptist Church have permission to photograph your child for advertising purposes?

Yes No

The registration fee is $15.00. In addition to the registration fee, each Clubber needs to purchase a uniform and workbook in order to participate in AWANA. Please check the appropriate items and make checks payable to First Baptist Church, designating that it is for AWANA.

Please see price list/order form below:

Puggles (2 years old by September 1)
*Required	Optional
Take Home Cards $13.00	Puggles T-Shirt $10.00 Puggles Praise CD $10.50 Puggles Baseball Cap $6.00
Order Total: $
Cubbies (3 & 4 years old by September 1)
*Required	Optional
Handbook $10.00 Vest $11.00	Handbook Bag $ 6.50 Cubbies T-Shirt $13.00
Order Total: $
Sparks (Kindergarten, 1^st, & 2^nd grades)
*Required	Optional
Handbook Book 1* $10.50 Handbook Book 2* $10.50 Vest $11.00	Handbook Bag $ 5.50 Sparks T-Shirt $14.00
Order Total: $
Handbook Book 1 is for new registrants. Handbook Book 2 is for children who have completed book 1.
T&T (3^rd, 4^th, & 5^th grades)
*Required	Optional
Handbook Book 1* $10.00 Handbook Book 2* $10.00	Handbook Bag $ 4.50 T&T T-Shirt $14.00
Order Total: $
Handbook Book 1 is for new registrants. Handbook Book 2 is for children who have completed book 1.
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