Awana Registration Form
Please fill one out for each child
Child's Details:
Full Name
*
First Name
Last Name
Address (this helps with needed pick-up/drop-off)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Will your child be riding the church van for pick-up/drop-off, or will they be brought by you or another adult?
*
Church Van
Personal
If your child will be using the church van for pick-up and/or drop-off, please provide the address(es) below. If the pick-up and drop-off locations are different, be sure to specify which is which.
Thank you!
Gender
*
Female
Male
Birthday
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Grade
*
Allergy/Medical Concerns
*
If None, please put None.
Are there any learning differences or disabilities we should be aware of or better support your child?
*
If None, please put None.
Guardian's Details
Please have at least TWO people on this form. Thank you!
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
example@example.com
If there is someone else that could be potentially picking up your child or someone else you would like to add for an Emergency Contact, please put their name, cell number, and relation to the child below.
*
I understand that my child/children may participate in activities such as held during Game Time. As with any physical activity, there is a risk of injury. I fully accept this risk and hold harmless from any legal liability Sweet Springs Baptist Church and any persons involved in the Awana Club ministry.
*
In the event of an emergency, that requires medical treatment, for the child named above/children, I understand that every effort will be made to contact me or my emergency contact. However, if I/we cannot be reached, I give my permission to the Awana volunteers to contact emergency services to provide the care necessary for my child's well-being. I assume responsibility for all costs connected to any accident or treatment of my child.
*
I grant permission for my child's photo to appear among other general club photos, as long as there is no identifying information shown.
*
I understand that I must inform the church of a changed address or phone number within 15 days for emergency purposes.
*
For safety purposes, I understand my child/children need to wear pants (not capris) and closed-toed shoes.
*
I understand that cell phones can be a distraction to both my child and others in the class. I agree that my child will not bring a phone to class, or that it will remain turned off and out of sight during Alana hours.
Signature
Submit
Submit
Should be Empty: