For all children two years old (by Sept 1) through 12th Grade
Please fill out form completely and click "Send Form" button.
Parent/Guardian Name(s):
Address:
City: State: Zip:
Home Phone: Cell Phone:
E-mail Address:
Child's Name: Nickname:
Birthday: Gender:
Grade: School:
Please list any allergies or medical conditions:
Child's Name: Nickname:
Birthday: Gender:
Grade: School:
Please list any allergies or medical conditions:
Child's Name: Nickname:
Birthday: Gender:
Grade: School:
Please list any allergies or medical conditions:
Child's Name: Nickname:
Birthday: Gender:
Grade: School:
Please list any allergies or medical conditions:
Please list any persons we can call in an emergency (please include phone number):
Please list persons who are permitted to pick up child(ren):
Who invited you to Awana and/or who will bring you to Awana?
Do you go to church regularly? If so, where?
Other important information:
Terms and Conditions
1. I understand that my child(ren) may participate in physical activities such as those 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, Crossview Baptist Church and any persons involved in the Awana Club ministry.
2. In the event of an emergency that requires medical treatment for the above-named child(ren), I understand 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 secure the services of a licensed physician to provide the care necessary for my child(ren)'s well being. I assume responsibility for all costs connected to any accident or treatment of my child(ren).
3. I grant permission for photos of my child(ren) to be taken for church use only.
4. I grant permission for my child(ren)'s Club leader, Director, or Commander to periodically contact my child(ren) by mail, email, or phone. If a home visit is desired, my permission will be requested beforehand.
5. I grant permission for my child(ren) to travel to/from Awana Club events with an adult leader. Any such event will be clearly communicated with me beforehand.
