AWANA 24-25 Form

Registration 2024-2025

Lincroft Bible Church
Father's Full Name

First NameLast Name
Mother's Full Name

First NameLast Name
Parent Cell Phone Number*

Area CodePhone Number
Parent Cell Phone Number

Area CodePhone Number
Email Address*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact (Other Than Parent)*

First NameLast Name
Emergency Phone Number*

Area CodePhone Number
List of Allergies, Medical Conditions, etc.
Did your child(ren) attend in prior years?

YesNo
Add child(ren) below:

You may pay in person at AWANA by cash, check or credit card.

	Child's Name	Boy (B) Girl (G)	Birth Date	Cubbies (Pre-K) Sparks (K-2nd) T&T (3rd-6th)	Uniform Size	Uniform Fee	Registration Fee ($15/Child)	Book Fee ($12) If Needed)	Subtotal For Child

Uniforms (Please DO NOT order this year until club meets in person.)

Lincroft Bible Church Medical & Photo Release From 2023-2024
Name(s) of Child(ren)*
I give permission for my children to attend and to participate in the AWANA activities. In case of emergency, every effort will be made to contact me. However, if I cannot be reached, I give my permission to the staff at Lincroft Bible Church to secure the services of emegerncy personnel/licensed physician to provide the necessary care, including anesthesia for my children's well being.

I understand that Lincroft Bible Church and the AWANA Program and its staff are not held responsible for any monetary incurrence for said medical treatment.
Parent's Name*

First NameLast Name
Signature*

Clear
Date*

MonthDayYear
Date
Permission to Use Photograph
I grant Lincroft Bible Church the right to take photographs of me and/or my family in connection with the AWANA program. I authorize Lincroft Bible Church, its assigns and transferees to copyright, use, and publish the same in print and/or electronically.

I agree that Lincroft Bible Church may use such photographs of me and/or my family and for any lawful purpose, including publicity, illustration, advertising, and web content.

I have read and understand the above.
Parent's Name*

First NameLast Name
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Registration 2024-2025