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AWANA Registration Form
Register your child/ren to the new AWANA session starting September 18th 2018
Email address *
Clubs
Please select the clubs your child/ren are eligible for *
Required
First Child's Information
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Second Child's Information
Child's First Name
Your answer
Child's Last Name
Your answer
Child's Date of Birth
MM
/
DD
/
YYYY
Third Child's Information
Child's First Name
Your answer
Child's Last Name
Your answer
Child's Date of Birth
MM
/
DD
/
YYYY
Fourth Child's Information
Child's First Name
Your answer
Child's Last Name
Your answer
Child's Date of Birth
MM
/
DD
/
YYYY
Street Address *
Your answer
House Number *
Your answer
Apartment or Suite Number (if necessary)
Your answer
City *
Your answer
Province *
Your answer
Postal Code *
Your answer
Medical Concerns / Allergies (If applicable)
Your answer
Medication Carried By Child
Your answer
Mother / Guardian Full Name
Your answer
Mother / Guardian Primary Contact Number
Your answer
Mother / Guardian Primary Email Address
Your answer
Father / Guardian Full Name
Your answer
Father / Guardian Primary Contact Number
Your answer
Father / Guardian Primary Email Address
Your answer
Do you give permission for an authorized leader of RCCG Overcomers' Chapel Awana Club to accompany your child listed on this form to a medical facility for treatment resulting from illness or injury at a regular Awana function or special event. Further, do you also provide your consent for your child to participate in periodic special events on and off site. I hereby release RCCG Overcomers' Chapel and Awana Clubs Canada, their directors, volunteers, employees and/ or representatives from any and all liabilities or claims for personal injury, illness or death which may be incurred by my child / children while participating in the above named program and its activities.
Do you authorize Awana Leaders or Parents to photograph your child during Awana activities. The photos will only be used for personal use, and/or used in the year end Awana slide show or on RCCG Overcomers' Chapel Awana web site.
I preauthorize the following individuals to pick up my child from Awana in my absence without any other notice. 
And I fully release and hold harmless RCCG Overcomers' Chapel and Awana Clubs Canada for any incidents that may occur after my child has been released into the custody of these individuals.
Your answer
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