AWANA GROUP                                                                                         HELP

  Cubbies  Sparks Pals  Chums 

  Pioneers Guards JV's  High School                                      

  Last Name  First  Middle 

  Street Address    

  Address (cont.)   

  City      State Zip Code     

  Date of Birth      

  Grade            Male        Female              

  Home Phone      Email Address   

  Family History

   Church member     Not a   Church member   

   Father's Name       

       Christian         Others    

   Mother's Name      

       Christian         Others    

   Your home church

    Emergency Contact

     Phone number   --