Awana Signup (2023-24)

First Name *

Last Name *

Date of Birth *

School Grade *

Tip: What grade is your child for the 2022-23 school year?

Gender

Phone Number

Tip: Use numbers only; do not use any dashes (-) or spaces.

Email Address *

Home Address

Home City

Home State

Home Zip Code

Allergies *

Special Needs *

Additional Health Info

Contact Name *

Contact Relationship

Contact Phone *

Contact Name (2)

Contact Relationship (2)

Contact Phone (2)