NSCBC

Awana Registration

Parent and Contact Information

Parent 1

Parent 1 First Name *

Parent 1 Last Name *

Email *

Mobile Phone *

Home Phone

Address *

Country

City

State

Zip code

Parent 2

Parent 2 First Name

Parent 2 Last Name

Mobile Phone

Home Phone

Address

Country

City

State

Zip code

Emergency Contact

Emergency Contact Name

Emergency Contact Phone

Additional Information

Besides the parents listed above, who is authorized to pick up your child?

Authorized Pickup 1

Authorized Pickup 2

If you attend a church which one do you attend?

Do you plan to attend the pizza dinner starting at 5:30pm? *

Yes

If you plan to attend the pizza dinner, how many should we plan for?

Additional Info

Is there any additional information that you would like to share with us?

Registration Fee *

I understand that there is a $30 registration fee per child, with a maximum of $75 per family per school year. This fee helps to cover the individual Awana books, uniforms, and awards.

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Awana Registration

Parent and Contact Information

Child Information

Additional Information