First Name:  
Last Name:  
Date of birth: DD/MM/YYYY  
Gender:
Grade/age:
Parents' Names:  
Street Address:  
Apt./Suite:
City:  
State:  Zip Code:
Email address:    
Home phone:
Work Phone:
Cell phone:
Church attending:
 
Suggested registration fee = $15 per family, however donations of any amount are welcomed.
Click to Calculate
Donation amount: $
Total amount due: $
May be broken into payments.
 

Generic answers above will be saved after submission allowing you to make easy multiple registrations.

Cubbie

Uniform:  $13.00
Handbook:  $7.00
K and grade 3 need to purchase a new book. Grades 1,2,4 and 5 need to purchase a book if last year's was completed.
 
Emergency Contact Information
Name:  
Relationship:  
Phone:  
Allergies or Special Needs
 
How did you hear about our AWANA Clubs?




 
I would like to request a scholarship