Awana Registration Parents Names*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Main Phone*Parents Email* Home ChurchClubber Name*Date of Birth*Male or FemaleFemaleMaleGrade in School*3 Years Old4 Years OldKindergartenGrade*3 - 5 Years OldKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeHandbooksAll clubbers will need a new handbook each year. Please check the one for the grade your clubber is in.Pre-School - 8th GradeHigh SchoolDoes the clubber need a uniform?Check any uniforms or accessories you would like to order. These items may also be ordered at a later date. Cubby Vest - $12 Cubby Bag - $7 Sparks Vest - $12 Sparks Bag - $7 T&T Bag - $9 T&T Uniform - $22 Uniform size, if needed. Cubby - 4 Cubby - 5 Cubby - 6 Spark - 6 Spark - 8 Spark - 10 Spark - 12 Spark - 14 Name of Emergency Contact*Phone for Emergency Contact*I hereby authorize the leaders of AWANA to act on my behalf when I cannot be contacted, IN CASE OF AN EMERGENCY, resulting in the need of medical attention for my child named above. I also agree to hold harmless the AWANA leadership and First Baptist Church of Silvis, IL, from any accidents as a result of my child's participation in its activities. Furthermore, I agree to reimburse First Baptist Church, Silvis, IL for all medical expenses.*I agreeI understand that photographs will be taken throughout the Club Year which may be used as part of the Parents and Awards Night slide presenttaion. I hereby give my permission for my child to be photographed for this purpose. I further understand that if I do not wish my child to be photographed, it is my responsibility to notify the Club Commander.*I agreeNameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.