Awana Clubber Information

Awana Clubber Information
Name*

First NameLast Name
FemaleMale
Birth Month*
Birth Date*
Enter the day of the month your child was born on
Birth Year*
Your child is too young to register for the Awana Program.
Your child will be in the Sparks Program (Senior Kindergarten - Grade 2)!
Your child will be in the Truth & Traning Program (Grade 3 - Grade 6)!
Your child will be in the Trek Program (Grade 7 - Grade 8)!
Your child will be in the Journey Program (Grade 9 - Grade 12)!
Your child is too old to register for the Awana Program.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
YesNo
Please elaborate on any allergies your child has that we should be aware of:
YesNo
Please elaborate on any medical conditions that we should be aware of:
YesNo
Please elaborate on any physical, emotional, or behavioural concerns that we should be made aware of:
Parents may stay with their child through the evening provided they sign-in at the entrance.

Guardian Information
Primary Guardian*

First NameLast Name
Primary Email Address*
example@example.com
Primary Contact Number*
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Number (Thursday Nights)*
Please enter a valid phone number.Format: (000) 000-0000.

Payment and Confirmation
Register for Awana*
If registration above is full, please register for the waiting list. We will contact you as spots become available
Based on your child's age, they will be registered in the:
Sparks Program (Senior Kindergarten - Grade 2)!
Truth & Traning Program (Grade 3 - Grade 6)!
Trek Program (Grade 7 - Grade 8)!
Journey Program (Grade 9 - Grade 12)!
Yes ($20)No
YesNo
To register, the parent or legal guardian of the applicant must read and agree to the following conditions:
1. I am the parent or legal guardian of the child registered above.
2. I grant my permission for the child registered above to participate in all activities of the Awana club at Bridlewood Bible Chapel.
3. I release all individuals and groups associated with Awana and Brildlewood Bible Chapel from any liability associated with accidents or sicknesses resulting from the child’s participation in these activities.
4. I grant my permission for a qualified professional to administer or seek emergency medical treatment for the child registered above in case of an emergency.
5. I give permission for the reasonable use of photos and videos of the child for any Bridlewood Bible Chapel-related promotions.
6. I give permission for the reasonable use of my email address for Awana program-related communications.
7. I acknowledge that I or a designated must come to Bridelwood Bible Chapel on September 11th between 6:30pm and 8:00pm to confirm registration and pick up the Awana book(s)/shirt(s) for my child(ren).
Yes
Total
Should be Empty:

Awana Clubber Information

Guardian Information

Payment and Confirmation