Please fill out the following information to register for AWANA.
Child's Name *
Street Address *
Street Address, Line 2
State * ---ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY
Zip Code *
Gender * MaleFemale
Date of Birth * ---JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember ---12345678910111213141516171819202122232425262728293031 ---200620072008200920102011201220132014201520162017
Grade * ---3 & 4 Years (Cubbies)K-2nd (Sparks)3rd-5th (T&T)
Siblings at AWANA
Parent/Guardian Name *
Mobile Phone *
Church You Attend
Emergency Contact Name *
Emergency Contact Phone *
Adult Authorized to Pick up Child
I hereby give my permission for my child to participate in AWANA Clubs. I authorize the staff of DBBC to obtain emergency medical treatment for my child if he/she becomes ill and I am unable to be contacted. *
I understand that I or an authorized adult must be present at check-in and dismissal every day of AWANA Clubs for the safety of my child. *
I hereby authorize DBBC to use photographs and videos of my child for publicity and promotional purposes which include, but are not limited to, in-house presentations, church websites, brochures, and newsletters. Children's names and other personal information are never used without specific permission. *
I would like to register my child to be served dinner on Wednesday nights at 5:45pm. We will only have enough food to accommodate those pre-registered for dinner. *
How did you hear about AWANA? *
---EmailFrom a friendA church memberWebsite
© 2020 Crossmark Church.
We continue to monitor the Coronavirus Epidemic and in keeping with County and City requirements, our plan is to continue with online services only until we are given the clear from federal, state and local authorities.
Please continue to join us online at 10:30am on Sunday mornings at:
If you need assistance, please email us at firstname.lastname@example.org.