CCCBR Awana Online Registration Form

Note: Please complete separate form for each of your children.

Child's Information

Child's name:                   Child's birthday:   

Child's grade:                   Child's Mailing Address:   

Guardian's Information

Guardian's name:              

Guardian's phone number:          Guardian's alternative phone number:  

Guardian's e-mail:            Guardian's address: 

  • List of persons allowed to pick up your child (note: phone ID is needed to pick up your child):
  • How did you hear about our Awana?
  • Is this your child's 1st year in Awana? Yes No
  • Would you be interested in serving in Awana? Yes No
  • Do you attend church somewhere? Yes No  
  • If so, which church? 

Version: 09/24/2011