Elders Baptist Church Awana Registration 2024-25 Club Year
Children aged 3 years-old through 5th grade are invited to join us Wednesdays 6:00-7:30 Sept-May for club! Parents are welcome stay with younger children and participate in club activities.
Parent/Guardian #1
*
First Name
Last Name
Parent/Guardian #2
First Name
Last Name
Email
*
example@example.com
Phone Number: Primary
*
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Child #1
First Name
Last Name
#1 Birthday
-
Month
-
Day
Year
Date
#1 grade: Prek-5
#1 grade:
PreK 3
PreK 4
K
1
2
3
4
5
Allergies/Medical/Education concerns #1
Child #2
First Name
Last Name
#2 Birthday
-
Month
-
Day
Year
Date
#2 grade:
PreK 3
PreK 4
K
1
2
3
4
5
Allergies/Medical/Education concerns #2
Child #3
First Name
Last Name
#3 Birthday
-
Month
-
Day
Year
Date
#3 grade
#3 grade:
PreK 3
PreK 4
K
1
2
3
4
5
Allergies/Medical/Education concerns #3
Child #4
First Name
Last Name
#4 Birthday
-
Month
-
Day
Year
Date
#4 grade
#1 grade:
PreK 3
PreK 4
K
1
2
3
4
5
Allergies/Medical/Education concerns #4
Pictures and video's permitted for AWANA club (including private FB group, church website, slideshows and boards).
*
YES
NO
I agree to KEEP MY CHILD(REN) HOME if they have FLU, Covid19 or are exhibiting any of the following symptoms: fever, excessive cough, shortness of breath, aches & pains, diarrhea, vomiting until they have been symptom free for a period of 2 days
*
YES
NO
Emergency Contact
*
First Name
Last Name
Emergency Contact Phone
*
-
Area Code
Phone Number
Other notes for leaders or questions:
I will be onsite during Awana (but not volunteering with Awana)
YES
NO
I will be Volunteering in Awana
YES
NO
Sometimes
Register
Should be Empty: