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