Awana Registration Form

Awana Registration Form

Please complete a separate form for each child you are enrolling.
Clubber Name: *

First Name Last Name
Clubber Birthday: *

Month Day Year
Age: *
Grade: *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Primary Phone Number *

Area Code Phone Number
Phone Number

Area Code Phone Number
New to Awana? *

Yes No
Club Level: *
Clubber Medical Conditions:
Clubber Allergies:
Parent/Guardian Name *

First Name Last Name
Parent/Guardian Cell Phone *

Area Code Phone Number
E-mail *
Parent/Guardian Name (#2)

First Name Last Name
Parent/Guardian Cell Phone

Area Code Phone Number
E-mail
Individuals authorized to pick up the child from club (with contact information): *
WAIVER
I acknowledge the contagious nature of the COVID-19 virus and acknowledge that
Watts Chapel Missionary Baptist Church (WCMBC) adheres to the CDC recommendations of practicing social distancing and wearing face coverings.

I further acknowledge that WCMBC has put in place preventative measures to reduce the
spread of the COVID-19 virus, to the best of its abilities. I acknowledge that no guarantee exists regarding whether or not my child may contract COVID-19. I understand that the risk of becoming exposed to and/or infected by the COVID-19 virus may result from the actions, omissions, or negligence of my child and others.

I am willingly allowing my child to participate in the AWANA Ministry and assume all responsibility. In the event a participant tests positive for COVID-19 within Forty-Eight (48) hours of an AWANA session, I hereby waive confidentiality and authorize WCMBC to disclose the participation list to the local public health authorities for the purpose of contact tracing.
Waiver Signature - signature doesn't have to be perfect, use your mouse to sign. *

Clear
Select one t-shirt/vest size under the appropriate age group:
Puggles 2-3 year old
Cubbies: 4-5 year old
Sparks: Grades K-2
Truth and Training: Grades 3-4
Truth and Training: Grades 5-6
Trek: Grades 6-8
Trek: Grades 6-8

Option 2
Journey: Grades 9-12
*You will need a new uniform if you are starting club for the first time, you are entering a new club (ie: Cubbies to Sparks or Sparks to T&T) or you are entering 5th Grade in the T&T program.

*You will need a new Handbook if are starting club for the 1st time, you are entering a new club (ie: Cubbies to Spark or Sparks to T&T), you are entering 5th Grade in the T&T program or you completed your handbook last year.
Note: All Awana Club leaders and listeners must submit to a background check before working with the childen.
Occasionally, I would like to contact your child to see how they are enjoying club and if they need help in completing their handbooks. I would also like to send written correspondence such as "Get Well" cards and a "Birthday" Card. I am asking your permission as the legal parent/guardian to contact your child by written communication and/or phone call to discuss club activities.
Parents Electronic Signature of Consent: *

First Name Last Name
Occationally we may take pictures of your child engaging in Awana activities. If you do NOT wish to have photographs of your child to be published through various communications of the Watts Chapel Missionary Baptist Church public relations purposes, please initial here:
Date Submitted *

Month Day Year
Do you choose to pay online? *

Yes No. I'll pay in person.
Online Payment

prev next ( X )
USD AWANA Registration
Should be Empty:

Awana Registration Form

WAIVER

Select one t-shirt/vest size under the appropriate age group: