AWANA Form

Parent/Guardian's Name

First

Last

Email

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Emergency Contact #1

First

Last

Emergency Contact #1 Phone

Emergency Contact #2

First

Last

Emergency Contact #2 Phone

Doctor's Name

Who will pick up your child on a weekly basis? (Must be 18 years old or older)

Child's Information

3-6) Grade and

Child's Name

First

Last

Date of Birth

Grade

List of Allergies (Type n/a if none)

List Any Major Illnesses (Type n/a if none)

List Regular Medications (Type n/a if none)

Cubbies Vest (3-year old & Pre-Kindergarten)

Sparks Vest (K5 - Grade 2)

T&T Shirt (Grades 3-6)

By signing this form, I give CBC permission to photograph my child and use his/her pictures in the church's perpetual digital and print communications.

I agree.
I disagree.

As a parent/guardian, I will do my part to ensure my clubber understands and follows the rules and expectations. As a parent/guardian, I also have the responsibility to help my child at home with their handbooks.

I agree.

Type full name for digital signature

Make a payment by:

PAY ONLINE (link at top of page): https://app.easytithe.com/App/Giving/crow100172
Pay at Awana Check-in
Worship Center Offering Boxes

AWANA

Child's Information

CONTACT

CONNECT