First Baptist Church of Leadville

Welcome to online registration

Please enter any allergies in the Special Notes section.

New Awana Registration

Household Information

Parent/Guardian #1 *

Relationship

Parent/Guardian #2

Relationship

Address *

City *

State *

Zip *

Enter alternate address for Parent/Guardian#2

Phone# *

Type

Receive Texts?

Address

City

State

Zip

Phone#

Type

Receive Texts?

Other Emergency Contacts (include phone numbers)

Please include a phone# and name for each of your Other Emergency Contacts.

List others authorized to pickup your child

What church do you attend?

Church attendance is NOT required. Enter NONE if you don't attend a church.

During meetings, I will normally be at

Website Login / Email

I don't have an email address

Email *

Alternate Email

New password *

Please enter a password you'd like to use to login to this site.

Uniform cost: Cubbies & Sparks - $10.00 -- T&T - $14.00 (Indicate what you are purchasing)

Child Information

First Name*

Last Name*

Gender*

Registration Type*

Grade for 2023-24*

Birthdate*

AWANA uniform

Shirt Size

Special Notes

Please enter any special notes that we should know about your child. For example, allergies, special instructions, etc.

Photo Release: Photographs are sometimes taken of Awana ministry activities for publicity and promotional purposes, which include, but are not limited to, in-house presentations, church web site, brochures and newsletters. By signing below, you are granting the church to use photographs of the above mentioned minor(s) as stated.

YES, I grant permission for use of photographs of my child as stated above

NO, I do NOT authorize use of photographs of my child

In lieu of your signature, please enter your initials:

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