Awana Registration 2025-2026

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. At the end of this form, you will be given an option to "Register Another Child".

Birth Date*

MonthDayYear
Age*
Pre-School children must be 3 before September 1st and must be potty trained.

Due to space limitations, the Pre-School class will be limited to the first 10 registrations.
Grade in school*

Does child have an IEP?*
IEP is an Individualized Education Plan which is a legal document signed with the school that allows child to receive special education services. This information will be helpful to us when we are working on assigning weekly memory verses.

PARENT / GUARDIAN INFORMATION
Please make sure one or both parents/guardians are available at listed phone number during Awana Club hours in case we need to get hold of you, or in case of an emergency.

We encourage you to put the church phone number in your contact list, so you know it's us calling and that you need to answer.

First Baptist Church 785-258-3207

All club announcements, cancellations, etc. will be sent by either TEXT or EMAIL. Please list here either the cell phone number or email address you would like to be notified on:*
If you choose to receive announcements via TEXT, you will need to do the following in order to start receiving notifications:

Text the word ALERT to 22300

AUTHORIZATION
If there are any additional individuals who are authorized to pick up this child (other than parents/guardians previously listed), please list their names here.

If their name is not on this list, they will NOT be able to pick up your child.
Name (first & last)
Name (first & last)
Name (first & last)

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, it's 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 attorneys' and consultants' fee and disbursements, which arise out of joining the Awana Club sponsored by First Baptist Church.*
Initial

I give permission for my child's photo, which may be taken during Awana to appear in any church publication, including the church's videos, websites, social media, publicity, and promotional materials, or display purposes. I hereby release the church and its employees and agents 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.*

In the event my child becomes ill or injured, I authorize the staff of Awana and/or First Baptist Church to authorize medical treatment as necessary to insure the well-being of my child.*

I understand that for PICK UP an adult must go inside the building to pick up my child. I also understand that if I chose UNSUPERVISED RELEASE that my child has permission to leave the building unaccompanied, and that once they check out and leave the building that First Baptist Church, it's staff, and leaders are no longer responsible for my child.*

Welcome to Awana Club