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New Awana Registration
Household Information
Parent/Guardian #1
*
Relationship
Dad
Grandparent
Guardian
Mom
Parents
Parent/Guardian #2
Relationship
Dad
Grandparent
Guardian
Mom
Parents
Address
*
City
*
State
*
Zip
*
Enter alternate address for Parent/Guardian#2
Phone#
*
Address
City
State
Zip
Phone#
Other Emergency Contacts (include phone numbers)
Please include a phone# and name for each of your Other Emergency Contacts.
List others authorized to pickup your child
What church do you attend?
Church attendance is NOT required. Enter NONE if you don't attend a church.
Website Login
I don't have an email address
Email
*
Alternate Email
New password
*
Please enter a password you'd like to use to login to this site.
Clubber Information
Registration Type
*
Clubber
Leader/Volunteer
Change to Leader/Volunteer if you're an adult registering to help with meetings
First Name
*
Last Name
*
Gender
*
Please select...
Boy
Girl
Grade for 2024-25
*
Please select...
2 years old [by Sept 1st] (Puggles)
Pre-School (Cubbies)
Kindergarten (Sparks)
Grade 1 (Sparks)
Grade 2 (Sparks)
Grade 3 (T&T)
Grade 4 (T&T)
Grade 5 (T&T)
Grade 6 (T&T)
Birthdate
*
Month...
January
February
March
April
May
June
July
August
September
October
November
December
Invited by
Special Notes
Please enter any special notes that we should know about your child. For example, allergies, special instructions, etc.
Medical Release:
As a parent/guardian, I give my permission for the above minor to attend Awana activities including regular club nights and any special activities from September 4, 2023 to May 1, 2024. I authorize treatment under the direction of any licensed physician of the above minor in the event of a medical emergency which in the opinion of the attending physician my endanger his or her life, cause disfigurement, physical impairment or undue discomfort if delayed. This authority is granted after reasonable effort has been made to reach me by phone. I will not hold the church, or their staff, administration, or workers, liable for any injury to or loss of possessions by the above minor during any activity either on the church property or away, including regular meetings as well as special events.
YES
, I give permission as stated above for my child regarding medical care
NO
, I do
NOT
give permission for my child to receive medical care
In lieu of your signature, please enter your initials:
Photo Release:
Photographs are sometimes taken of Awana ministry activities for publicity and promotional purposes, which include, but are not limited to, in-house presentations, church web site, brochures and newsletters. By signing below, you are granting the church to use photographs of the above mentioned minor(s) as stated.
YES
, I grant permission for use of photographs of my child as stated above
NO
, I do
NOT
authorize use of photographs of my child
In lieu of your signature, please enter your initials:
Covid-19 Release:
Exposure to COVID-19 is an inherent risk in any public location where people are present. I acknowledge that any procedures put in place by the church will not eliminate the risk of COVID-19 and I accept the risk of the above minor participating in this activity.
YES
, I consent to the above
In lieu of your signature, please enter your initials:
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Devon Clark
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