2017-2018 AWANA Registration
Please enter the following information if you would like your child to join AWANA at FCBC. Parent must sign a permission form for each child to participate. Registration fee of $30 per child will be collected anytime before or on Child's first AWANA night. Please make checks payable to "FCBC" with "AWANA" in the memo line. AWANA starts Sept 8 at 7:30pm.
Email address
Child's first and last name
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Child's Primary Language
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Child's grade (Sept 1, 2017)
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Child's birth date
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Child's food allergies
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Parent's First & Last name
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Cell phone number
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Home address (street and zip code)
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Any comments/questions/notes
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MEDICAL RELEASE ON BEHALF OF MINOR AND HOLD HARMLESS AGREEMENT
1.) My child/children may be giving reasonable emergency medical treatment in connection with all church events, and I authorize the person(s) in charge of the activity to administer, arrange for, and authorize such emergency medical care and treatment in my place and stead. I knowingly and voluntarily WAIVE AND RELEASE all claims and causes of action of any kind whatsoever (other than for gross negligence or willful misconduct) against FCBC, its elders, pastors, officers, staff and volunteers, which I or my child/children may hereafter have by reason of or relating to my child/children’s participation at FCBC including injury, illness, or death of my child/children and damage to any property or the property of my child/children. I UNDERSTAND THAT THE CLAIMES AND CAUSES OF ACTION HEREBY WAIVED AND RELEASED INCLUDE THOSE BASED IN WHOLE OR IN PART, ON THE ORDINARY NEGLIGENCE (BUT NOT GROSS NEGLIGENCE OR WILLFUL MISONDUCT) OF FCBC, ITS ELDERS, PASTORS, OFFICERS, STAFF OR VOLUNTEERS.

2.) I give permission for photo(s) of my child/children to appear among other general club photos in any and all media as long as there is no identifying information published by FCBC. I hereby waive any causes of action I may have because of the use of my child’s photograph.

I have read and agree to the Terms and Conditions stated above.

E-Signature and date
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