Awana Registration 2017-18
***ONE REGISTRATION FORM NEEDED PER CHILD! ***
PAY AFTER REGISTERING LAST CHILD!

Puggles (2 by August 1) - Parents REQUIRED to attend a Wednesday night activity or Bible study - only snack fee required.
Cubbies (3 by August 1)
Sparks: Kindergarten - 2nd grade
T&T: 3rd-6th grade
Trek - 7th-8th grade
Journey - 9th-12th grade
NOTE: Trek & Journey meet on Sunday nights at 5:15; all others meet on Wednesdays at 6:30 p.m.

Child's Name
Your answer
Gender
Parent/Guardian Name
Your answer
Street Address
Your answer
City/Zip Code
Your answer
Phone
Your answer
Alternate Phone
Your answer
Email
Your answer
Age
Your answer
Grade
(If Preschool, put PS)
Your answer
Birthday
MM
/
DD
/
YYYY
Medical or other information we need to know. Please include food allergies.
Your answer
Emergency Contact (other than listed above)
Name & phone number
Your answer
Emergency Contact
Name & phone number
Your answer
Who may pick up your child at the end of each Awana night?
Your answer
Who may pick up your child at the end of each Awana night?
Your answer
Does your child attend Sunday School?
Required
If so, where?
Your answer
How did you hear about Awana?
Your answer
May we have permission to photograph your child?
Required
May we have permission to use your child’s photograph in church publications for the purpose of promotion?
Required
Medical Release: As Parent and/or Guardian, I do hereby authorize the treatment by a qualified and licensed medical doctor of the minor noted above in the event of a medical emergency, which, in the opinion of the attending physician, may endanger his/her life, causing disfigurement, physical impairment, or undue comfort if delayed. This authority is granted only after a reasonable attempt has been made to reach me. This release is completed and signed of my own free will with the sole purpose of authorizing medical treatment under emergency circumstances in my absence for the PBC Awana year 9/6/17 through 5/23/18. Typing your name and date constitutes your signature and acceptance of these terms.
Your answer
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