Awana Club Registration

Please fill out one Registration form per child.

Suggested Donation: We are asking for a suggested donation of $40.00 to cover the cost of the Uniform, Book, and Grand Prix Racer Kit. 100% of the donation will go towards the purchase of the above-listed items. Please make checks payable to Dix Hills Evangelical Free Church.

We're looking forward to a fantastic year ahead.

Childs Name:(Required)

Please enter your child's first and last name

Date of Birth(Required)

Parent/Guardian:(Required)

Phone Number(Required)

EMail(Required)

Address(Required)

Emergency Contact(Required)

Phone number:(Required)

Current Grade(Required)

For Preschool age only: Is your child potty trained?

Yes

Not yet

Please list any medical needs, allergies or restrictions we should know about your child.(Required)

Uniform Sizes Cubbies (Vest - 3 & 4 yr old)

Uniform Sizes Sparks Vest (K-2nd Grade)

Uniform Sizes T&T (3rd - 6th Grade)

Photo and video release: I give my permission to take and use photo(s)/video of my child for uses associated with Awana Clubs at Dix Hills Evangelical Free Church (please sign below)