Awana Online Registration Form
Awana Online Registration Form
First Baptist Church of Ogden, Pennsylvania
Child's Name (first & last)
Street Address & Apt. #
City
State
Choose one:
Delaware
New Jersey
Pennsylvania
Other
Zip Code
Child's Gender
Boy / Male
Girl / Female
Child's Age:
Choose one:
4
5
6
7
8
9
10
11
12
13
Child's Date of Birth -- Month / Day / Year
Grade in School
Choose one:
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Other
Home Phone #:
Child lives with:
Choose one:
Both Father & Mother
Mother
Father
Grandparent
Other
Mother's Name / First & Last name please
Mother's Cell Phone #:
Father's Name / First & Last name please
Father's Cell Phone #:
E-mail Address - used for announcemnets, schedule changes, snow cancellations, etc.
Backup Contact & phone # of person not listed above.
Backup Contact Person's relationship to the child.
Please let us know if your child has any life threatening allergies or if there are any custodial issues of which we should be aware. You may also clarify any "Other" information options above.
REGISTER
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