2024-2025 Awana Cubbies Registration (3 & 4 year olds)

Please fill out this form and click submit. We realize you will need to fill out the parent information more than once, but please understand that this will help make sure your child's information is correct, since it is directly from you.
Once you complete registration and pay online, you will be all set on the first night of club!!

Name

Address

Gender

Please select one option.

Male Female

Age

Birthdate

ALLERGY/MEDICAL

Vest Size

Please select one option.

Sm (4) Med (5) Large (6) XLarge (8) XXLarge (10) No Vest Needed

Dad's Name

Mom's Name

Email address for club reminders and information:

This address will receive a confirmation email

Cell Phone for club night contact:

Emergency Contact Information (Other than parents)

Emergency Contact Name

Emergency Contact Phone Number

Other

Home Church

How did you hear about us?

Registration Payment

This is the 1st child I have registered this year. ($30) This is the 2nd child I have registered this year. ($30) This is the 3rd child I have registered this year. ($15) This is the 4th (or more) child I have registered this year. ($0) Pay on the first day of Club ($0) Request Financial Assistance ($0)

Amount

Vest Payment

Vest ($14) No Vest ($0) Pay on the first day of club ($11) ($0)

Amount

Book Payment

Book ($12) No Book ($0) Pay on the first day of club ($11) (0)

Amount

Bookbag

Bookbag ($7) No Bookbag ($0) Pay on the first day of club ($7) (0)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

2024-2025 Awana Cubbies Registration (3 & 4 year olds)

Description

Please Fix the Following