CABC Awana Online Registration
The cost per child  is $24.00 for the year for the
1st and 2nd  child and $12.00 for the 3rd child.  
Child Information
First Name
 Last Name
Gender:
 Age
Grade
 Date of Birth (mm/dd/yyyy):
City:  
 State:
 Zip Code:
Address:
List any medications
Home Telephone Number:
List any allergies:
Parental Information
Father's Name:
 Mother's Name:
Mother's Email Address
Father's Email Address
Father's Cell Phone:
Mother's Cell Phone:
If we need to get in touch with you while your child is in club
what number should we call
Emergency Information
If we are unable to reach either parent in the event of an emergency,
please list who we should contact and how to reach them.
Telephone:  
Name:
Name:
 Telephone:  
New International Version (NIV)
King James Version (KJV)
New King James Version NKJV
Medical Release forms must be provided for each child member in order for them to participate in
games and special events (hikes, AwanaGames, etc. ) Please provide a medical release for each child.
click here to download the
2008 - 2009  Medical Release Form
To add other children in the
family continue below.
To add additional children continue below. When all children have been added use the "Submit all
children" button at the bottom of the page
#2 Child Information
Gender:  FM    
First Name
Last Name
Date of Birth
(mm/dd/yyyy):
 List any allergies:
List any medications
Age
Grade
#3 Child Information
Gender:  FM    
First Name
Last Name
List any allergies:
 List any medications
Date of Birth
(mm/dd/yyyy):
Age
Grade
#4 Child Information
Gender:  FM    
First Name
Last Name
List any allergies:
 List any medications
Date of Birth
(mm/dd/yyyy):
Grade
Age
#5 Child Information
Gender:  FM    
First Name
Last Name
List any allergies:
List any medications
Date of Birth
(mm/dd/yyyy):
Grade
Age
#6 Child Information
Gender:  FM    
First Name
Last Name
List any allergies:
List any medications
Date of Birth
(mm/dd/yyyy):
Grade
Age
updated 7/5/08