AWANA 2018 Registration
Registration for Stow Alliance Fellowship AWANA Program:
There are fees for books and uniforms. Once registration form is complete you will be contacted about fees for your family.
Parent Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Zip Code *
Your answer
Email address *
Your answer
Phone number *
Your answer
Name of Emergency Contact (Other than Parent listed Above) *
Your answer
Phone number of Emergency Contact *
Your answer
Preferred Doctor: Name and phone number *
Your answer
Preferred Hospital: Name *
Your answer
Medical Release Statement
Medical Release Statement I understand that, in the event of a medical emergency while my children is under the care of Stow Alliance Fellowship and its representatives and I am not available, Stow Alliance Fellowship will call for emergency medical treatment. I hereby consent to and will be responsible for any reasonable medical treatment as deemed necessary by a licensed physician. I understand that every possible attempt will be made to contact me in the event of an emergency. I agree to hold the physician, medical facility, Stow Alliance Fellowship and its representatives free and harmless of any claims, demands or suits for damages arising from the authorization and provision of such medical treatment.
Parent/Guardian Name
By typing my name here, I am stating I have read and agree to all the information above and I am the legal parent or guardian of the children listed below
Type Name here: *
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of Stow Alliance Fellowship. Report Abuse - Terms of Service - Additional Terms