2018 Awana Registration Form
Awana registration for Fall 2018 is now open. Please fill out the registration form below for each child that you would like to register. You can also contact awana@tccbc.org if you have any questions.
Child's Name *
Your answer
Gender *
Boy
Girl
Gender
Birth Date (month/day/year) *
MM
/
DD
/
YYYY
Age *
Your answer
Grade in the fall (pre-K, K, 1-12) *
Parent's Names *
Your answer
Cell Phone *
Your answer
Work Phone *
Your answer
Email Address *
Your answer
Home Address *
Your answer
Language(s) *
Your answer
Name of Siblings Also in AWANA
Your answer
Home Church (if any)
Your answer
Alternative Emergency Contact Name & Phone # *
Your answer
Doctor's Name and Phone # *
Your answer
Medical Plan & Policy # *
Your answer
Please list any allergies and their treatment (especially food, drug or insect allergies) *
Your answer
Please list any ailments or disabilities that might restrict your child's activities *
Your answer
Medication & current dosages *
Your answer
Are all medical shots up to date? *
I hereby consent to have my child participate in AWANA activities supervised by the leaders of Tri-City Chinese Baptist Church at the church, or away from the church grounds to nearby points of interest from September 2018 to June 2019. I hereby authorize the leaders of Tri-City Chinese Baptist Church to call an emergency ambulance in case of an accident or acute illness, and to arrange for necessary emergency medical and surgical care. Any qualified physician called by Tri-City Chinese Baptist Church may treat and do whatever is necessary for the health and well being of my child. I also agree to accept responsibility for any cost connected with such treatment and hereby release Tri-City Chinese Baptist Church from any liability. *
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