Awana Registration Form
Cornerstone Christian Church
Parent Information
Parent Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
*
example@example.com
Child 1 Information
Child 1 Full Name
*
First Name
Last Name
Child 1 Birthday
-
Month
-
Day
Year
Date
Child 1 Age
Child 1 Grade
Child 1 Shirt Size (youth sizes XS-XL and adult sizes S-5XL)
Please list any allergies your child has and any other important medical information for Child 1:
*
Child 2 Information
Child 2 Full Name
First Name
Last Name
Child 2 Birthday
-
Month
-
Day
Year
Date
Child 2 Age
Child 2 Grade
Child 2 Shirt Size (youth sizes XS-XL and adult sizes S-5XL)
Please list any allergies your child has and any other important medical information for Child 2:
Child 3 Information
Child 3 Full Name
First Name
Last Name
Child 3 Birthday
-
Month
-
Day
Year
Date
Child 3 Grade
Child 3 Age
Child 3 Shirt Size (youth sizes XS-XL and adult sizes S-5XL)
Please list any allergies your child has and any other important medical information for Child 3:
Child 4 Information
Child 4 Full Name
First Name
Last Name
Child 4 Birthday
-
Month
-
Day
Year
Date
Child 4 Age
Child 4 Grade
Child 4 Shirt Size (youth sizes XS-XL and adult sizes S-5XL)
Please list any allergies your child has and any other important medical information for Child 4:
Photo and Medical Release
Photo Release- I hereby grant the above named church permission to copyright and use photographs/videos taken at Awana of the minor(s) designated above in any manner or form for any purpose lawful at any time. I waive any right that I may have to inspect or approve the finished product or written copy, that may be used in conjunction therewith, or the use to which it may be applied.
Yes
No
Medical Release- I give my permission for the Cornerstone staff and volunteers to administer basic first aid to my child/children (named above) in the event of an injury. I understand that the Cornerstone staff and volunteers will contact emergency services in the event of a significant injury and all expenses for such emergency services will be paid by me.
Yes
No
Signature
Parent's Name
Submit
Should be Empty: