AWANA Child Registration
Child's Name (Last Name, First Name)
Your answer
DOB
MM
/
DD
/
YYYY
Sex
Grade Level *
AWANA Club
Allergies?
Your answer
Who is authorized to pick child up?
Your answer
Parent/Guardian Name
Your answer
Address
Your answer
Parent Phone Number(s)
Your answer
Parent Email Address
Your answer
Member at FIFBC?
If not a member at FIFBC, does your family regularly attend another church? Which one?
Your answer
Photographs are sometimes taken of activities for publicity and promotional purposes, which include, but are not limited to in-house presentations, church websites, brochures, social media, and newsletters. Children's names or information are never used without specific information. Please check your preference below.
I, the undersigned parent or guardian, hereby consent to my child participating in AWANA sponsored by FIFBC. If my child has medical conditions which may be relevant to the program, I have listed them above. If I cannot be reached, I hereby authorize any adult connected with the program involved, including any physicians and/or hospital, to implement any reasonable medical care, including surgery, deemed necessary, for the welfare of my child. If there are any activities I do not want my child to participate in, I have listed them above. I also release and agree to hold harmless FIFBC as well as its members, and everyone else connected with the described program from any and all claims, cause of action, and the like, arising out of injury to my child. Furthermore, the information that I have provided is accurate to the best of my knowledge. (Please initial below.)
Your answer
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