Bella Vista Baptist Church
50 East Lancashire Blvd.

Bella Vista AR  72714 

 

 

~ AWANA REGISTRATION FORM ~
 
for 2011-12 School Year
 
Times:  Wednesdays from 6:30pm - 7:45pm
 
 
You can register your family with this one form

 

 

Parent's Names (please include first & last names):                            E-mail Address:
           


Mailing Address                                                                          City                                                   Zip
            


#1 Contact Phone #:                        #2 Contact Phone #:                        #3 Contact Phone#:
                     

 



Children's Information:                         Date of Birth:      

   // Male  Female   

 

   // Male  Female   

 

   // Male  Female   

 

   // Male  Female   

 

   // Male  Female   

 

   // Male  Female   

 

   

 

  **Puggles Club is for 3 year olds (must be 3 by 08/01/11) AND must have a parent volunteering at the church during this time on Wednesday evenings.

 

 


If any of the children listed above have allergies or medical conditions please list below:

 

 

We require a Medical Release form for all children to attend.  This ensures

 

that we have up-to-date food allergy and medical information on each child. 

 

You can download a copy of our Family Medical Release Form from the

 

RESOURCES page on our site.  Either mail in or bring with your child to the

 

first night of AWANA.

 

 





Bella Vista Baptist Church

50 East Lancashire Blvd.

Bella Vista AR  72714
 


Phone: 1-479-855-3748

staff@bvbaptist.com