Awana, Cubbies & Pearls RegistrationIf you are registering more than one child, please fill out the form again for each additional child. Parent's Name * First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * May we text you? * Yes, please No, thank you Emergency Contact (other than stated parent) * First Name Last Name Emergency Contact Phone Number * (###) ### #### Children's Information Name of Child First Name Last Name Child's Date of Birth Which program are you registering this child for? Cubbies (Preschool Boys & Girls Age 3-4) Awana (Boys & Girls K thru 2nd grade) Pearls (Young ladies in grades 3-12 / Ages 8-18) Child's Grade Child's Address (if different than address given above) Address 1 Address 2 City State/Province Zip/Postal Code Country Does this child have allergies? If "yes," please specify. Thank you! Your completed registration form has been received. You may now close this window.
