2023-2024 AWANA Registration Form

WELCOME! We're excited for another fun Awana season! :)

Important! When filling out this form:

Click on each payment field (including the scholarship fund), regardless of how many children you are registering. You will need to click on each and enter an amount or select “0.”

*T&T PARENTS: ALL T&T kids need a new book at the beginning of each Awana season!!!

If this is a financial hardship for your family, please move each payment field to zero and click the scholarship button at the bottom. Thank you!

By registering your child, you are consenting to your children being photographed and on video for Heartland social media and promotional channels.

If you would like more information about opting out, please email our Communications Coordinator Rachael at rbomsta@heartlandfree.com

How did you hear about us?

Parent/Guardian Name

This address will receive a confirmation email

Phone

Address

Emergency Contact Name

Emergency Contact Phone

Child #1 Name

Date of Birth

Grade entering fall of 2023

Pre-K K 1st 2nd 3rd 4th 5th

Dues (required)

Shirt/Vest (if needed)

Book (if needed) *T&T-required

Child #2 Name

Date of Birth

Grade entering fall of 2023 Pre-K K 1st 2nd 3rd 4th 5th

Dues

Shirt/Vest (if needed)

Book (if needed)

Child #3 Name

Date of Birth

Grade entering fall of 2023 Pre-K K 1st 2nd 3rd 4th 5th

Dues (required)

Shirt/Vest (if needed)

Book (if needed)

Child #4 Name

Date of Birth

Grade entering fall of 2023 Pre-K K 1st 2nd 3rd 4th 5th

Dues (required)

Shirt/Vest (if needed)

Book (if needed)

This is a financial hardship, please use scholarship fund Yes

Sponsor a child (donate to scholarship fund)

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

2023-2024 AWANA Registration Form

Description

Please Fix the Following