AWANA 22-23 Sign Up
Please fill out this form to get your child signed up and ready for Awana this school year.
West Lynchburg Baptist Church
Child's Name
Child's Birthdate
Child's Grade for school year 2022-23
Please select one option.
Toddler
Preschool
K
1st
2nd
3rd
4th
5th
6th
7th
8th
Which group will the child be in?
Please select all that apply.
Puggles (ages 2-3)
Cubbies (ages 4-5)
Sparks (K-2)
T&T (3rd-5th)
Trek (6-8th)
Parent/Guardian Name
Email
Phone
AWANA fee per child for the entire year
1 Childâž¡$15
3+ Child Discountâž¡$0
1 Childâž¡$15
3+ Child Discountâž¡$0
Amount
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
Please fill out this form to get your child signed up and ready for Awana this school year.
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