2024-25 AWANA Registration

For Kids Grades JK to 5. Wednesdays 6:30-8:00 pm.

Child Information

Child's full name *

Home Address

City

Postal Code

School Grade *

Age (as of September 30, 2024) *

Child's Birthday (mm/dd/yyyy): *

Child's Ontario Health Card # *

Allergies/Medical

Has this child participated in Awana previously?

Yes

There is a suggested registration fee of $25 per child to help cover the cost of materials.

Parent / Guardian Information

Parent/Guardian Name: *

Telephone # *

Is there anyone who MUST NOT pick up your child?

EMERGENCY Contact Information

Contact Person / Relationship: *

Tip: Please list an additional emergency contact.

Emergency Phone No(s): *

In case of a medical emergency, I hereby give authority to any hospital and/or emergency medical personnel to render immediate medical aid, including transport if necessary, for the child(ren) listed, as may be required at the time for their health and safety. *

Yes, I consent.

No, I do not consent.

Special instructions or needs: