Dutchtown Baptist Church
 
 
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Awana Registration
Child's Name:
Parent / Gaurdian Name:
Address:
City: State: Zip:
Phone Numbers:
Home: Work: Cell:
Email:
Age Information:
Birth date (for preschoolers) or last grade completed in school:
Medical Information:

Medical or other information we need to know. (Please include any food allergies.)

Emergency Contact:
Name: Phone:
Name: Phone:
Dismissal Information:

Who may pick up your child at the end of each Awana?

Other Information:
Do you attend Sunday School? If so where?
If you are visiting our church, who are you a guest of?

May we have permission to photograph your child?

Yes No

May we have permission to use your child’s photograph in church publications for the purpose of promotion?

Yes No
T-Shirt Size:
   
© Dutchtown Baptist Church • dutchbc@eatel.net • 36495 C. Braud Road • Prairieville, LA 70769 • (225) 673-6612 • (225) 673-6624