AWANA Registration 2024/2025

Form
2024-2025 AWANA Club Registration Form

A form must be completed for each child registering
Cubbie, 3 & 4 yr-olds
Spark, K - 2nd Grade
Flame, 3rd - 5th Grades
Torch, 6 - 12th Grades

Child's Name

First NameLast Name
Below, in Box #1, if the child's last name is different from parents - please provide a last name we can normally "identify" with your family that you prefer. In box #2, please initial here if you DO NOT wish to have your child's photo or video used in AWANA or GCC media, online, or in any form.

Box #1 Family NameBox #2 - Nothing used in media/online/anyform
Birth Date & Grade

Mo/Day/YrGrade
Club Name you are registering for:

Cubbie - Annual Fee $60 Includes dues and books but do not include the required uniform - (used for 2 years) or any optional suppliesSparks - Annual Fee $60 Includes dues and books but do not include the required uniform (used for 3 years) or any optional suppliesFlames - Annual Fee $60 Includes dues and books but do not include the required uniform (used for 3 years) or any optional suppliesTorches - Annual Fee $125 (Includes dues and books but do not include the required uniform or any optional supplies
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother's Name
Mother Phone Number
Please enter a valid phone number.
Father's Name
Father Phone Number
Please enter a valid phone number.
Child's Cell Number
Please enter a valid phone number.
Parent's Email
example@example.com
Child's Email
example@example.com
This permission slip is for participation in AWANA events furing the 2024-2025 year. I, being the parent or legal guardian of the above child, give my permission for my minor to attend and participate in AWANA events on or off campus. In the event of an emergency, I give my consent for emergency medical and surgical treatment of this minor in a licensed hospital or emergency clinic by a licensed Colorado physician should his/her condition so require in my absence. I understand in such a case, a reasonalbe attempt will be made to contact me, time and conditions permitting, as long as the medical and surgical treatment considered necessary in the situation is in accordance with generally accepted standard of medical practice for the particular type of injury or illness involved. I impose no specific limitations or prohibitions regarding the treatment other than those that follow:
Emergency Information

In case of an emergency we will contact the parents of the legal guardians at the phone#'s given. If you cannot be reached, is there anyone else that you would like us to contact?
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship to the minor:
Child's Medical Doctor

First NameLast Name
Phone Number
Please enter a valid phone number.
Insurance Information
I understand that if major medical attention is not necessary, basic first aid and/or acetaminophen will be administered by an AWANA Leader

Signature

Clear

Child Release/Parental/Guardian Instruction and Consent and Allergy Form for 2024/2025

Your children and their safety ae out TOP priority! Please let us know of any special situations/custody issues we need to be aware of . We ask that you fill out this form pertaining to the release of your child at the end of each AWANA night. Leaders will be aware and informed of your speicifications, and will require checkout by an approved person on this form. In addition, please list any allergies or medical conditions we need to be aware of. In addition, please initial if children have permission to leave campus for various field trips/off campus excursions.
My child First Name Last Name may be picked up by the following people during the 2024/2025 AWANA Program.
Name #1

First NameLast Name
Relationship to Child #1
Name #2

First NameLast Name
Relationship to Child #2
Name #3

First NameLast Name
Relationship to Child #3

If applicable to your family:
My child First Name Last Name may NOT leave with:
Name

First NameLast Name
Relationship to Child
Name

First NameLast Name
Relationship to Child
Signature & Date

Clear
Allergies

Any allergies we need to be aware of for snack purposes and/or medical information that we should be aware of :
Please list allergies
My child has permission to leave campus with approved leaders for field trips

YesNo
Should be Empty:

Form

2024-2025 AWANA Club Registration Form

Cubbie, 3 & 4 yr-olds

Spark, K - 2nd Grade

Flame, 3rd - 5th Grades

Torch, 6 - 12th Grades

Emergency Information

Child Release/Parental/Guardian Instruction and Consent and Allergy Form for 2024/2025

If applicable to your family:

Allergies