Please fill out the form below to register for AWANA at Community Bible Church.


AWANA Registration
Name of Child
Age
Date of Birth
Grade
Street Address
City
State
Name of Legal Guardian
Legal Guardian Phone Number
Emergency Contact 1 Name
Emergency Contact 1 Phone Number
Emergency Contact 2 Name
Emergency Contact 2 Phone Number
Member at Community	Yes No
If no, where do you regularly attend church?
Do you give permission to put pictures of the child named above to appear on our church web page?	Yes No
By checking the box to the right I commit to completing and submitting a Medical Release Form.
You may on obtain a copy of the Medical Release Form when you drop your child off for AWANA.
By checking the box to the right I, the legal guardian named above, submit that all of the information given above is completely true.
We count it such a privilege to have your child in the AWANA ministry. Your trust is valuable to us! Because of the careful screening of all AWANA workers, we are excited that we are able to provide fun Bible learning in a completley safe environment. -Joe Esarey Lead Pastor at Community