2025-2026 Awana Registration Form ← BackYour registration has been sent. Child #1 Name:(required) Grade in School:(required) Date of Birth: (YYYY-MM-DD)(required) Gender:(required) Male Female Allergies and/or Special Needs: Child # 2 Name: Grade in School: Date of Birth: (YYYY-MM-DD) Gender: Male Female Allergies and/or Special Needs: Child # 3 Name: Grade in School: Date of Birth: (YYYY-MM-DD) Gender: Male Female Allergies and/or Special Needs: Child # 4 Name: Grade in School: Date of Birth: (YYYY-MM-DD) Gender: Male Female Allergies and/or Special Needs: Parent Name:(required) Address:(required) City:(required) State:(required) Zip Code:(required) Phone Number:(required) Email:(required) Name of Home Church: Emergency Contact Name:(required) Emergency Contact Phone:(required) Who will normally pick up your child(ren)(required) Does Parent or Emergency Contact Person usually attend the HBC prayer meetings? Yes No Submit FormSubmitting form Δ
Heritage Baptist Church, Orefield PA