AWANA Child Registration

AWANA CHILD REGISTRATION

August 2022-May 2023

* Indicates required field

Child's Name *

First

Last

Gender *

Male Female

Birthdate *

Age *

School Grade *

Select One *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone Number *

Cell Phone Number *

Email *

Parent/Guardian Name *

First

Last

Church you regularly attend, if any: *

Will Your Child Need a Shirt or Vest? (There is a charge for uniforms) *

If your child has allergies, please list them below: *

Other Care Notes including any Medical Constrictions *

Medications *

Special Info:
Photographs are sometimes taken of children's ministry activities for promotional purposes, which include but are not limited to, in-house presentations, church websites, brochures and newsletters. Children's names and information are never used without specific permission.

Liability Release
I give my child permission to attend AWANA Club and participate in all AWANA Club related activities. It is expressly desired that participant described herein be an active participant in the activities of AWANA Club Participant is believed to be in satisfactory health and free from communicable disease. It is understood that there are certain risks involved in activities related to AWANA Club. It is understood and agreed that West Acres Baptist shall not be responsible or legally liable for any losses of personal property or for any bodily injuries (or the results thereof) incurred and suffered by participant in connection with AWANA Club, unless such loss or injury results directly from the negligent or willful act of any West Acres staff. In the event I (parent/guardian) cannot be reached or am rendered unconscious, I hereby give permission to the physician selected by West Acres Staff to hospitalize, secure proper treatment for, order injections, anesthesia and/or surgery for my child in case of an emergency. By typing my full name below I (Parent/Guardian) agree and consent to all above stated.”

Parent/Guardian Full Name *

Submit