2025-2026 Awana Registration Form

Awana Registration Form (2025-2026)

If you are filling this form out on a phone or tablet, landscape view works best when filling in the Child/Children's Information table.

Child/Children's Information

	First.Name	Last.Name	Nickname	Birthday	Age	Grade
Child #1
Child #2
Child #3
Child #4
Child #5
Child #6

Family Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Name of the Church you attend
Is there an additional parent/guardian to include on the registration*

YesNo
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.

Medical Release
Are there any special needs or allergies for your child/children we should be aware of?*

YesNo
Please list special needs or allergies for each child below
As a parent and/or guardian, I do herewith authorize treatment under the direction of a licensed physician of the above minor(s) in the event of a medical emergency which in the opinion of the attending physician, may endanger his or her life, cause disfigurement, physical impairment or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me by phone at the phone number listed below.

The undersigned assumes the responsibility for any cost connected with such treatment and hereby releases Bethel Baptist Church Awana Club from any liability therefore.

The release form is completed and signed of my own free will with the sole purpose of authorizing medical treatment under emergency circumstances in my absence
Signature for Medical Treatment Authorization*

First NameLast Name
Please indicate your role of the above signed*

FatherMotherGuardian
Family Physician
Physician Phone
Health Insurance Name
Insurance Phone Number
Please enter a valid phone number.
Specific Medical Conditions, Chronic Illnesses, or Other Conditions
Additional Emergency Contact

First NameLast Name
Phone Number
Please enter a valid phone number.

Bethel Security Information & Acknowledgement
Please Read

The Security Team here at Bethel is working hard to ensure the security of the children attending Bethel's Children's programs. The following is information we would like all of our parents to be aware of.

1. Children need to be signed in and out by a parent/guardian or a person otherwise designated in your profile

2. We will add into your profile name of those who may or may not pick up your child/children.

3. When signing in you child/children a name tag may be issued for the child/children, as well as, an ID tag for you as parents. This tag will need to be used in order to pick up you child/children. If the ID tag is lost or another individual, you have designated in your profile, picks up a child/children, a photo ID will be required.

4. If your child/children brings a guest they will be signed in under your name and the above rules apply.

5. There will be no exceptions to the above information.

Thank you for entrusting your child/children into our care. We hope these implementations will be a further step in caring for your children here at Bethel.

By signing below you have read the above information and are in agreement. Should you have any questions, please contact us to discuss them.
Authorized to pickup (Must be 13 years or older)
Please indicate who is authorized to pick up your children from AWANA, in addition to the parents/guardians listed above. We will not release them to anyone not previously approved by you.
Unauthorized to Pickup
Please indicate if there is anyone whom you do not want you child/children release to
Are there any Family Court Orders in place with your family?*

YesNoNot Applicable
Please explain your family court orders
Signature for acknowledgement of security update*

First NameLast Name
Date Signed*

MonthDayYear
Date
Please indicate your role of the above signed*

FatherMotherGuardian
Image Release

I understand that church events are often photographed/recorded for publication and public relations (i.e. end-of-year videos, website promo’s, flyers, etc), and I hereby grant irrevocable permission to the Bethel Baptist Church AWANA Club to indefinitely use photos/videos of my child(ren) for these purposes (including, but not limited to print, screen projection, the internet, etc). I waive my right to inspect and approve such use, but such use must be related solely to this AWANA Club, AWANA activities, and church and must not identify my child by name. I release the church from any and all claims arising out of said use, including but not limited to claims of libel and invasion of privacy.
I approve of Bethel using images of my child as listed above

YesNo
Signature

First NameLast Name

Sizes	Quantity
Small (size 4)
Medium (size 5)
Large (Size 6)

Sizes	Quantity
Small (Size 6)
Medium (Size 8)
Large (Size 10)
X-Large (Size 12)
2 XL (Size 14)
3 XL (Size 16)

Sizes	Quantity
Youth M
Youth L (Size 14)
Adult Small
Adult Medium
Adult Large

Awana Registration Form (2025-2026)

Medical Release

Bethel Security Information & Acknowledgement

Please Read

Image Release