Awana Registration 2024-2025

Before registering your child for Awana Club, please read the Parent Guide. This contains important information you need to know about the policies and procedures of Herington Awana Club. Click on the link below.

Parent Guide
I have read the Parent Guide and agree to follow the policies and procedures of Herington Awana Clubs*

Yes
CLUBBER INFORMATION

A separate form must be filled out for each child
Clubber Name (first & last)*
Gender*
Address*

Address

Street Address Line 2

CityState / Province

Zip
Birth Date*

MonthDayYear
Date
Church Attending
Age*
Due to space limitations, the Pre-School class will be limited to the first 12 registrations
Grade in school*
Does child have an IEP?*
An IEP is an Individualized Education Plan. This is a legal document signed with the school that allows your child to receive special education services.
Siblings (names, ages)
PARENT / GUARDIAN INFORMATION
Clubber lives with*
Mother Name (or Guardian #1)
Home Phone
Cell Phone
Email
example@example.com
Father Name (or Guardian #2)
Home Phone
Please enter a valid phone number.
Cell Phone
Email
example@example.com
All club announcements, cancellations, etc. will be sent by either TEXT or EMAIL. Please list here either the cell phone number, or the email address you would like to be notified on:*
If you chose to receive announcements via TEXT you will need to do the following in order to start receiving notifications:

Text the word ALERT to 22300
TRANSPORTATION & AUTHORIZATION
Transportation TO club will be*
***PLEASE READ BEFORE CHOOSING YOUR RELEASE OPTION***

PARENT PICK UP: Parent must come inside and go to the child's classroom to pick them up. Parent must be with the child for check-out.

UNSUPERVISED RELEASE (6th-12th graders ONLY): Parent does not need to come inside. Child will be allowed to check out and leave the building without parent being present. Once your child has checked out of club and leaves the building, First Baptist Church will no longer be responsible for that child. (If you have other children younger than 6th grade, you will still have to come inside to pick those children up.)

WALK, RIDE BIKE, DRIVE SELF: Child will be allowed to check out and leave the building without parent being present. Once your child has checked out of club and leaves the building, First Baptist Church will no longer be responsible for that child.

Once you have indicated your child's release status, you will need to contact the Club Administrator if you wish to make a change.
Transportation FROM club will be*
Below you must list all individuals who will be authorized to Pick-Up your child from club.

Please note: IF THEIR NAME IS NOT ON THIS LIST, THEY WILL NOT BE ABLE TO PICK UP YOUR CHILD.
The following individual is authorized to pick up clubber: Name Relationship to Clubber
The following individual is authorized to pick up clubber: Name Relationship to Clubber
The following individual is authorized to pick up clubber: Name Relationship to Clubber
MEDICAL INFORMATION
Medical conditions and/or Allergies
RELEASE & CONSENT
PLEASE READ AND INITIAL EACH OF THE FOLLOWING:
I agree that I hereby hold harmless and waive any and all claims against First Baptist Church, its staff and leaders for any accident, bodily or personal injury, damage to or loss or theft of any property, illness or death of any person, including without limitation demands, liabilities, damages, judgements, losses, costs, expenses and/or penalties, including attorney and consultant fees and disbursements, which arise out of joining the Awana Club sponsored by First Baptist Church.*
Initial
I give permission for my child's photo to be taken during Awana Club and used in any church publication, including the church's videos, websites, social media, publicity, promotional materials, or display purposes. I hereby release the church, its staff and leaders from all claims and liability relating to said photographs. IF YOU DO NOT WANT YOUR CHILD'S PHOTO PUBLISHED YOU MUST MARK "NO" IN PLACE OF INITIALS.*
Initial
In the event my child becomes ill or injured, I authorize the staff of Awana or First Baptist Church to authorize medical treatment as necessary to insure the well-being of my child.*
Initial
I understand that ONLY an authorized parent or individual (who are listed on this form) can pick up my child and MUST COME INSIDE THE BUILDING to do so. I also understand that if I designate on this form that my child has permission to walk, ride bike, or drive themselves that once my child checks out of club and leaves the building that First Baptist Church, its staff and leaders are no longer responsible for the safety of my child.*
Initial
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

CLUBBER INFORMATION

PARENT / GUARDIAN INFORMATION

TRANSPORTATION & AUTHORIZATION

MEDICAL INFORMATION

RELEASE & CONSENT