Awana Weekly Checkin
Please do not fill out this form until the day of the afternoon of Awana each week.
Today's Date
*
-
Month
-
Day
Year
Date
Clubber Name
*
First Name
Last Name
Awana Club
*
Cubbies - (Ages 3 - 5)
Sparks - (Kindergarten - 2nd grade)
T&T - (3rd grade - 6th grade)
Trek - (7th grade - 8th grade)
Journey - (9th grade - 12th grade)
Does this child have symptoms consistent with COVID19?
*
Yes
No
Has this child been in direct contact within the last 14 days with someone who has had a positive case of COVID19?
*
Yes
No
Has this child tested positive of COVID19 in the last 14 days?
*
Yes
No
Is this child awaiting the results of a COVID19 test that has been administered due to symptoms or suspicion of contracting COVID19?
*
Yes
No
Parent Signature
*
Clear
Submit
Should be Empty: