Excelsior Springs Baptist Church
Saturday, January 16, 2021
Christ Centered. Bible Believing. Family Focused.
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AWANA Registration 2020-2021 School Year
Child's Name
Date of Birth
Age
Grade
Siblings Attending
Parent Name
Address
City
State
Zip
Home Phone
Cell Phone
Work Phone
Church Home
Emergency Contact (persons to contact in case parents cannot be reached)
Name
Phone
Relationship to Child
Name
Phone
Relationship to Child
Allergy/Health Conditions
My child has permission to attend and participate in AWANA for the 2019-2020 school year, a ministry of Excelsior Springs Baptist Church.
Yes
No
Date
My child has permission to be photographed/video graphed as part of AWANA.
Yes
No
Date