AWANA Registration Human Verification Ten minus five equals Registration Form Registering for club: Puggles (2yrs old) Cubbies (3-4yrs old) Sparks (k-2 grade) TNT Girls (3-6 grade) TNT Boys (3-6 grade) (required) First Name(required) Last Name(required) Grade Date of Birth(required) Address(required) City State Zip Code E-Mail(valid email required) Home Phone(required) Cell Phone 1(required) Cell Phone 2 Mom's Name(required) Dad's Name(required) Name of person bringing / picking up child(required) Name of child's doctor Emergency Contact Name (other than parents)(required) Emergency Contact Phone 1(required) Emergency Contact Phone 2 Home Church Invited to AWANA by I am interested in helping with AWANA cforms contact form by delicious:days