Bella Vista Baptist Church
50 E. Lancashire Blvd.  .  Bella Vista, Arkansas  72714  .     (479) 855-3748


Register for AWANA

2008-09  

    NOTE:  We must have a signed, completed Medical Release Form on file for any child to attend AWANA  you can print this form out and mail to our church office. -- Please complete the parent/guardian information on this page.

 

First Child's Name               AWANA CLUB

  

     Age:           Date of Birth:   MM    DD  YY

     Gender:    Male    Female

     Current Grade in School:  

 

Second Child's Name            AWANA CLUB

        

     Age:           Date of Birth:   MM   DD  YY

     Gender:    Male    Female

     Current Grade in School:  

 

Third Child's Name                   AWANA

           

     Age:           Date of Birth:   MM   DD  YY

     Gender:    Male    Female

     Current Grade in School:  

 

Fourth Child's Name          AWANA

         

     Age:           Date of Birth:   MM   DD  YY

     Gender:    Male    Female

     Current Grade in School:  

 

Fifth Child's Name                     AWANA

         

     Age:           Date of Birth:   MM   DD  YY

     Gender:    Male    Female

     Current Grade in School:  

 

******************************************************************************************************  

 

Parent / Guardian Information:

Father's First Name:  Father's Last Name:

Mother's First Name:  Mother's Last Name:

Address
City
State   Zip
Home Phone Cell
E-Mail Address
Emergency Contact #1   Phone:
Emergency Contact #2 Phone

 

 

List any medical information (including food allergies) and the child's name that it pertains to in this box:

Do you regularly attend Sunday School?

If yes, where: 

If you are visiting our church, who are you a guest of:

 

Please contact me - I would like to help!

 

  

 

  
 
50 E. Lancashire Blvd.  .  Bella Vista, Arkansas  72714  .     (479) 855-3748