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AWANA REGISTRATION FORM


PARENT INFORMATION

First Name*
Last Name*
Address*
City*
State
Zip Code*
Phone*
Email*
Home Church (if any)

CHILD(REN) INFORMATION

NOTICE

New uniform is required for all Puggles, 1st year Cubbies, 1st year Sparks, 3rd graders, and 5th graders. Other years can re-use uniforms.

Number of Children Registering*
1 Child
2 Children
3 Children
4 Children
5 Children

CHILD ONE INFORMATION

Name*
Date of Birth
Gender
Grade
Allergies
Uniform (Child One)
Yes (Uniform Child 1)
No (Uniform Child 1)
Handbook Bag / Backpack (Optional)
Yes (HB/BP Child 1)
No (HB/BP Child 1)

CHILD TWO INFORMATION

Name
Date of Birth
Gender
Grade
Allergies
Uniform (Child Two)
Yes (Uniform Child 2)
No (Uniform Child 2)
Handbook Bag / Backpack (Optional)
Yes (HB/BP Child 2)
No (HB/BP Child 2)

CHILD THREE INFORMATION

Name
Date of Birth
Gender
Grade
Allergies
Uniform (Child Three)
Yes (Uniform Child 3)
No (Uniform Child 3)
Handbook Bag / Backpack (Optional)
Yes (HB/BP Child 3)
No (HB/BP Child 3)

CHILD FOUR INFORMATION

Name
Date of Birth
Gender
Grade
Allergies
Uniform (Child Four)
Yes (Uniform Child 4)
No (Uniform Child 4)
Handbook Bag / Backpack (Optional)
Yes (HB/BP Child 4)
No (HB/BP Child 4)

CHILD FIVE INFORMATION

Name
Date of Birth
Gender
Grade
Allergies
Uniform (Child Five)
Yes (Uniform Child 5)
No (Uniform Child 5)
Handbook Bag / Backpack (Optional)
Yes (HB/BP Child 5)
No (HB/BP Child 5)
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CONTACT US

4906 Melaleuca Lane,
Greenacres, FL 33463

561-963-9150

This email address is being protected from spambots. You need JavaScript enabled to view it.

Our church offices are open Tuesday through Friday 9:00 am to 3:00 pm.

SERVICE TIMES

Sunday Morning

10:00 Worship Service

11:30 Sunday School

Tuesday

7:00pm College and Career

Wednesday

6:30pm AWANA
6:30pm Youth Group
7:00pm Adult Bible Study

Copyright (c) 2016 West Pines Church. All Rights Reserved.

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