AWANA Registration Form

Agape House of Worship, Roselle, NJ – 2020/2021 AWANA Club Registration Form( Virtual)

To register your children, kindly complete this form and drop at (or mail to) the Church address below with your registration fee of $25/child. The fee covers the books and vest for the whole year.

Make checks payable to RCCG Agape House.

"*" indicates required fields

First Name

Last Name

DOB

Vest Size

Grade

Allergies

Parent/Legal Guardian*

Parent's Email*

Address

City

State

Zip Code

Home Phone

Cell Phone

Church Membership

Yes

Church Name

Emergency Contact Name & Phone Number

Person Authorized to Pick up Child

CAPTCHA

This field is for validation purposes and should be left unchanged.

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Jesus In Everything

AWANA Registration Form

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