Awana Registration Form

Parent's / Guardian's Names:

*First and Last:
First and Last:
*Address:
*City, ZIP:
*Phone Number:
Cell Number:
Email Address:
Name of Home Church:
Mapleview Awana Registration Fees:
$40 registration fee each for first 2 clubbers, $20 for each additional clubber
Please be sure to check the 2011-2012 Awana Pricing List for costs of additional required club items.
*Clubber #1 Name:
*Date of Birth:
*Child's Club:
Clubber #2 Name:
Date of Birth:
Child's Club:
Clubber #3 Name:
Date of Birth:
Child's Club:
Clubber #4 Name:
Date of Birth:
Child's Club:
Please complete an additional registration form if registering more than four clubbers.

Mapleview Awana is always looking for dedicated and caring workers!
Please let us know if you would be willing to help as a:
in the following club(s):	Puggles Cubbies Sparks T&T Trek Journey

2011-2012 Mapleview Awana Registration