Registration for AWANA Clubs at FBC Palmetto

AWANA Club Registration - 2025/2026

First Baptist Church of Palmetto
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Cell Phone Number*
Format: (000) 000-0000.
E-mail
example@example.com
Cell Phone Carrier (verizon, att, t-mobile, etc.)*
Home Church
Persons (other than parents) authorized to pick up your children
Emergency Contact Phone - During Club Time (other than parents)*
Emergency Contact Name*
Number of children you are registering
Child Information

Complete the following for the first child you are registering
Child's Name*

First NameLast Name
Nickname
Birthdate*

MonthDayYear
Date
Gender*
Grade*
Book Needed?
Uniform Needed?
Club
Doctor's Name*
Doctor's Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Last TD Shot

MonthDayYear
Date
Allergies / Meds / Special Needs
Child Information

Complete the following for the second child you are registering
Child's Name*

First NameLast Name
Nickname
Birthdate*

MonthDayYear
Date
Gender*
Grade*
Book Needed?
Uniform Needed?
Club
Doctor's Name*
Doctor's Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Last TD Shot

MonthDayYear
Date
Allergies / Meds / Special Needs
Child Information

Complete the following for the third child you are registering
Child's Name*

First NameLast Name
Nickname
Birthdate*

MonthDayYear
Date
Gender*
Grade*
Book Needed?
Uniform Needed?
Club
Doctor's Name*
Doctor's Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Last TD Shot

MonthDayYear
Date
Allergies / Meds / Special Needs
Child Information

Complete the following for the fourth child you are registering
Child's Name*

First NameLast Name
Nickname
Birthdate*

MonthDayYear
Date
Gender*
Grade*
Book Needed?
Uniform Needed?
Club
Doctor's Name*
Doctor's Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Last TD Shot

MonthDayYear
Date
Allergies / Meds / Special Needs
Child Information

Complete the following for the fifth child you are registering
Child's Name*

First NameLast Name
Nickname
Birthdate*

MonthDayYear
Date
Gender*
Grade*
Book Needed?
Uniform Needed?
Club
Doctor's Name*
Doctor's Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Last TD Shot

MonthDayYear
Date
Allergies / Meds / Special Needs
Child Information

Complete the following for the sixth child you are registering
Child's Name*

First NameLast Name
Nickname
Birthdate*

MonthDayYear
Date
Gender*
Grade*
Book Needed?
Uniform Needed?
Club
Doctor's Name*
Doctor's Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Last TD Shot

MonthDayYear
Date
Allergies / Meds / Special Needs
If you are interested in helping with AWANA, please contact the Children's Ministry office at (941) 722-7795. Note: All Awana Club leaders and listeners must apply and submit to a background check before working with the children.
Terms and Conditions
1. I understand that my child/children may participate in physical activities such as those held during GameTime. As with any physical activity, there is a risk of injury. I fully accept this risk and hold harmless from any legal liability, First Baptist Church of Palmetto and any persons involved in the AWANA Club Ministry.

2. In the event of an emergency requiring medical treatment for the above named child/children, I understand every effort will be made to contact me or my emergency contact. However, if I/we cannot be reached, I give my permission to the First Baptist Church AWANA leaders to secure the services of a licensed physician to provide the care necessary for my child's well being. I assume responsibility for all costs connected to any accident, illness or treatment of my child. 

3. I understand that temperatures may be taken upon admittance to AWANA and if my child(ren) and/or I exhibit symptoms related to COVID, or any other illness, admittance will be denied. 

4. I grant permission for photos/video of my child(ren) to appear in FBC related publications including print, video, website and social media. I also give permission for photos/video of my child(ren) to appear among other general club photos as long as my child's (children's) name(s) is not identified.
I have read and agree to the Terms and Conditions stated above

Payment Information*

AWANA Child Registration

Select how many children will be attending.

$35.00 Child(ren)
Item subtotal:$0.00

Enter coupon

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

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AWANA Club Registration - 2025/2026

Child Information

Child Information

Child Information

Child Information

Child Information

Child Information

Terms and Conditions