AWANA and Youth Registration Form

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Please fill out a form for each child that will be participating in AWANA or Youth Group at Bethany.

Email *

Child's Name *

Age *

Grade *

Birthdate *

YYYY

Address *

Parent/Guardian Name *

Emergency Phone Number *

Email Address *

Allergies or Other Health Concern

As parent/legal guardian of the child named above, I give my permission for him/her to attend the Bethany Baptist Church AWANA Club and/or Youth Group. I understand and acknowledge that participation in the activities involves inherent risks. I agree to indemnify Bethany Baptist Church for any costs or expenses arising out of my child's participation in activities including the cost of any medical care given to my child or any expenses or fees incurred in any lawsuit arising as a result of any damage or injuries caused by my child in the course of his or her participation in the activity. Bethany Baptist Church takes no other responsibilities outside of meeting expectation of provision of initial first aid. *

Yes I give my permission and agree

Please check here to signify online signature

Required

Please type name as indication of signature. *

A copy of your responses will be emailed to the address you provided.

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