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
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We look forward to having in-person worship services beginning June 7! If you’d like to join us in person, please send us an email at email@example.com with who all is coming so that we can plan accordingly.
For those who choose to do so, you can still catch our services online at 10:30am on Sunday mornings at:
If you need assistance, please email us at firstname.lastname@example.org.