Hi! Thanks for registering for the AWANA 2016-2017 year!

We just need a few pieces of information to help us better serve you and your kids.
Start
 
What is your child's first name? *

 
What is {{answer_27197884}}'s last name?

 
Is {{answer_27197884}} male or female? *


 
Which group will {{answer_27197884}} be registering for? *

Note:  Cubbies MUST be potty trained and MUST have a parent/guardian remain on the premises.

 
What is {{answer_27197884}}'s date of birth? *

 
How old will {{answer_27197884}} be on September 1st? *

 
What is {{answer_27197884}}'s address? *

 
What are the names of {{answer_27197884}}'s parents or legal guardians? *

 
What is your relationship to {{answer_27197884}}? *


 
What is your home phone number? *

 
What is your cell phone number?

 
Does {{answer_27197884}} currently attend a church?

     
 
If your previous answer was "yes", where does {{answer_27197884}} attend church?

 
Who may pick {{answer_27197884}} up from AWANA other than you?

MUST be 18 years old or older!
 
Please list all allergies, medical conditions, and any medications being taken that we should be aware of:

 
Are there any situations that we need to be aware of? *

     
 
If your previous answer was yes, please let us know so that we can give {{answer_27197884}} the best care possible while he/she is with us.

 
In the event a parent/guardian cannot be reached in an emergency situation, please contact: *

 
What is {{answer_27199231}}'s relationship to {{answer_27197884}}? *

 
What is the best phone number for contacting {{answer_27199231}}? *

 
Is there anyone other than those already listed that we can contact in the event of an emergency? *

     
 
If your previous answer was yes, what is the contact's name?

 
What is {{answer_27199718}}'s relationship with {{answer_27197884}}?

 
What is the best phone number for contacting {{answer_27199718}}?

 
Emergency Treatment: *

If emergency treatment is required and parents/guardians cannot be notified immediately, I give my consent for transport to the nearest emergency room.
     
 
Photographs: *

Photographs are sometimes taken of children's ministry activities for publicity/promotional purposes which include, but are not limited to:  in-house presentations, bulletin boards, church bulletin inserts, newsletters, and websites.  The names and/or information of children are NEVER used without SPECIFIC permission.  By signing this area, you are releasing First Alliance Church to use PHOTOGRAPHS of your child as stated above.
     
 
Digital Registration *

By clicking "I accept", I digitally sign this registration form and submit it as {{answer_27197884}} {{answer_27198667}}'s registration for this year's AWANA!
     
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