Register for AWANA Club at Covenant Baptist Church

AWANA Registration 2011-12

Please fill in the information below to register for AWANA Club at Covenant Baptist Church. There is a $25 enrollment fee which helps to cover materials to get you started and an awards vest or t-shirt. Scholarships are available.

Step 1 of 3

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Child's Name
FirstLast
Address
Street AddressCityStateZip Code
Home Phone
Cell Phone
Age
Gender
- Male
- Female
Birthdate
Grade
Mother's Name
FirstLast
Father's Name
FirstLast
Email
Enter EmailConfirm Email
Home Church
New to AWANA?
- Yes
- No
Allergies or other concerns

Insurance Information
Main Insured's Name
FirstLast
Relationship to Child
Parents' Business Phone
Doctor's Name
FirstLast
Doctor's Address
Street AddressCityZip Code
Doctor's Phone
Insurance Carrier
Policy Number
In Case of Emergency Contact Name
FirstLast
In Case of Emergency Contact Phone

You have completed filling out the form. If you have another child to register, click "submit". You will be taken to another page where you can register your next child. Please remember that there is a $25 enrollment fee which helps to cover materials to get you started and an awards vest or t-shirt. Scholarships are also available.

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