AWANA Registration Online Form

If registering more than one child, please fill out new form for each child.

Parent 1 Name *
Parent 1 Name
Parent 2 Name *
Parent 2 Name
Home Phone *
Home Phone
Cell Phone *
Cell Phone
Please include name, address, and phone/e-mail
Child's Name *
Child's Name
Child's Birthdate *
Child's Birthdate
As of August 2019
Electronic Signature Agreement By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Agreement. By selecting "I Accept" using any device, means or action, you consent to the legally binding terms and conditions of this Agreement. You further agree that your signature on this document (hereafter referred to as your "E-Signature") is as valid as if you signed the document in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature, and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting agreement between you and Prairie Baptist Church. You are also confirming that you are the person authorized to enter into this Agreement. You further agree that each use of your E-Signature constitutes your agreement to be bound by the terms and conditions of these Disclosures and Agreement as they exist on the date of your E-Signature on this form.