AWANA Registration
Child's Name / Last Name *
Your answer
Birth Date *
MM
/
DD
/
YYYY
School Grade *
Your answer
Address
Your answer
Parent/Guardian's Name *
Your answer
Phone/Cell Phone *
Your answer
E-mail
Your answer
Medical Release *
As parent/legal guardian for the above named child, I give permission for FBC personnel and AWANA leaders to seek medical treatment for my child if sick or injured, until a parent/guardian can be located. I give permission for first aid to be rendered. I assume responsibility of any cost connected with such treatment.
Photograph Release *
I give permission for publication/use of photography taken during club time. I understand these photos and/or videos may be posted on Fellowship Bible Church's website and/or Facebook Page.
Additional Phone
Your answer
Is child allergic to any medications? *
Required
List Allegies or any medications
Your answer
Are there any medical conditions that we need to be aware of?
Your answer
Emergency Contact (Name & Phone #)
Your answer
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