2023 Awana Registration

Child Information

Child's Name

Birthdate

Gender

Male Female

Allergies/Medical Conditions

For allergies/medical conditions type 'N/A' or 'None' if not applicable.

Parent Information

Parent's Name

This address will receive a confirmation email

Phone Number

Address

Preferred Contact Methods

Text Email None

Additional Parent/Guardian (if you can't be reached)

Additional Parent/Guardian Phone Number (if you can't be reached)

Emergency Medical Release

In the event of an emergency where medical treatment is required, I give my permission to the Awana leaders or church staff to obtain the services of a licensed physician. Please attempt to notify me immediately concerning any such emergency. I assume all financial responsibility for any expenses incurred.

I hereby acknowledge that Grace Community Church, its staff, or Awana leaders cannot be held responsible for any injury to my son/daughter.

Typing your name below is an acknowledgement of the above statement.

Parent Name to Acknowledge

Date of Acknowledgement

2023 Awana Registration

Description

Please Fix the Following