AWANA Registration Form

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Ages : Toddlers--- 6th Grade

Awana will start Sunday Aug. 9th, 5:30pm-7pm

There is a $10 per child fee for t-shirts. You can pay cash or check to Burnsview Baptist. You may also pay online via our website. Click on the "Giving" link and put Awana Fees in the notes section. If you pay online please notify Mrs. Shelley when you're done.

Child's First & Last Name *

Parent's First & Last Name *

Your Phone Number *

Home Address *

Grade level for 2026/2027 School Year *

Toddler

2 & 3 yr old

4K & 5K

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

6th Grade

Middle School

High School (9th-12th)

Please select a method of Pick Up for your child *

I will walk in and pick up my child

I would like to pick up my child in the car line

My child will be picked up by the Church Bus (If you were visited by a Burnsview representative or we left information on your door; you may select this option) )

Emergency Contact other than yourself (Full Name & Phone Number) *

Does your child have any allergies or sensory issues that you would like their teachers to be aware of? *

Are there any child custody issues that our teachers need to be aware of? *

What is your child's t-shirt size? *

Youth XS

Youth S

Youth M

Youth L

Youth XL

Adult S

Adult M

Adult L

Adult XL

Other:

Medical Release and Waiver of Liability:

I understand that in the event that medical treatment is required, every effort will be made to contact me at the number given above. However, if I cannot be reached, I give permission to Burnsview Baptist Church or any adult sponsor of the Church to secure services of EMS and/or a licensed physician to provide the necessary medical attention, including anesthesia, for my child's well being.

I the parent or legal guardian of the child named above, release Burnsview Baptist Church, together with the adult sponsors in charge, of any and all claims resulting from injury or damage that may be sustained by my child while participating in the Awana Club at Burnsview Baptist Church, to include transportation on the Church Bus. This waiver applies to the child listed above effective 08/9/26 to 05/02/27

I agree

I disagree

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