AWANA - Child Registration

Child' First and Last Name

Child's Age

Date of Birth

Grade

First and Last Name of Parent/Guardian

Relationship

Address Street

State

Zip Code

Daytime Phone

Evening Phone

Emergency Contact Name:

Relationship to Child:

Emergency Phone Number

Please list any specific medical allergies, chronic illness, or other conditions.

Please type your full name and relationship to the child below:

Email Address

PARENTS: Are you willing to become a qualified volunteer and participate once a month?

Wheeler Avenue Baptist Church

(713)748-5240
3826 Wheeler Avenue
Houston TX, 77004

Sunday: 8:00AM, & 11:30 AM
Sunday School: 10:00 AM
Children's Sunday School: 8:00 AM
Children's Church: 11:30 AM