13617 Midland Road Poway, CA 92064 Worship Times: 9:30 & 11:00 am


Awana Sign Up


Your Information

Your Name (required)

Your Email (required)

Your Phone (required)

Church you Attend

Relationship to Child (required)

Address (required)

City (required)

State (required)

Zip (required)

Child's Information

My child(ren) has/have previously attended an Awana program.

Child's Name (required)

Child's Date of Birth (required)

Grade for 2016-2017 (required)

Gender (required)
BoyGirl

Allergies, Medications, or Other Special Information

Does your child have learning difficulties, or require special and/or additional assistance? Please explain:

Awana materials include a vest/uniform, handbook, and book bag. Returning clubbers may only need to purchase a handbook, unless they are still working on a previous book. Clubbers can only move onto to the next book once they have complete the ENTIRE previous book (review is optional). New clubbers or returning clubbers moving into a new club level will need to purchase a vest/uniform, handbook, and book bag. Prices are as follows:

– vest/uniform $20 (includes the price of patches and jewels)
– handbook $15
– book bag $10

Vest/Uniform (required)

Vest/Uniform Size

Book (required)

Bag (required)

Sibling Information


Fill out this section if you are also signing up your child's sibling(s) for Awana.

Sibling 1 Name

Sibling 1 Date of Birth

Sibling 1 Grade

Sibling 1 Gender
BoyGirl

Sibling 1 Allergies, Medications, or Other Special Information

Does your child have learning difficulties, or require special and/or additional assistance? Please explain:

Vest/Uniform (required)

Vest/Uniform Size

Book (required)

Bag (required)

Sibling 2 Name

Sibling 2 Date of Birth

Sibling 2 Grade

Sibling 2 Gender
BoyGirl

Sibling 2 Allergies, Medications, or Other Special Information

Does your child have learning difficulties, or require special and/or additional assistance? Please explain:

Vest/Uniform (required)

Vest/Uniform Size

Book (required)

Bag (required)

Emergency Information

Emergency Contact Name (other than parent) (required)

Emergency Contact Relationship to Child (required)

Emergency Contact Phone Number (required)

Family Doctor

Physician's Phone

Insurance Carrier Name

Insurance Policy Number

Subscriber Name and or Subscriber #

By selecting Yes, I agree that the child(ren) listed above may receive any necessary first aid treatment from a duly licensed physician, or be admitted to the hospital in case of emergency. If the above named child(ren) needs emergency treatment and neither the parent nor the family physician can be contacted, consent is hereby granted for such emergency treatment as may be considered necessary in the opinion of the attending physician. In addition, I will not hold Cornerstone Church of Poway, its members, or any other Awana worker or the organization liable for any illness or accident to my child(ren) listed above. The child’s family assumes the responsibility for any costs connected with such treatment thereof while the child(ren) is on their way to, from, or at Awana. This authorization is given pursuant to California Civil Code, Section 25.8.

By selecting Yes, I agree that Cornerstone Church of Poway may take, use, and display photos of the child(ren) listed above on the church website and related promotional venues and materials throughout the year. Names will not be displayed with photos.

Any additional information you would like to add?

Parent Leaders

Which club do you wish to work in?

If you wish to work with a specific child, please list the name here:

T-Shirt Size (adult sizes),

Have you completed the background check?

After you have completed this form and pressed the Send button go back to the Awana Page to pay the registration fee.