awanaClubRegFormTitle

Please bring cash or a check, payable to Crossroads Fellowship, for $25 per clubber to the AWANA registration table. We will assess uniform needs during the first few weeks of AWANA. Thank You!

Students Name *
Students Name
Gender *
Birth Date *
Birth Date
Birth date of the AWANA Club student
Grade AWANA Club student will be attending in Fall
Parent/Guardian *
Parent/Guardian
Home Phone
Home Phone
Cell Phone
Cell Phone
Address *
Address
Member of a Church
Has your child been involved in AWANA previously?
Emergency Contact (only used if parents cannot be reached) *
Emergency Contact (only used if parents cannot be reached)
Emergency Contact Number *
Emergency Contact Number