Phone number *
Phone type Mobile Home Work Other
Household members
Add your clubber's name here, ONE child submission per form. For each additional child start a NEW form.
+ Add adult + Add child What program is this child participating in? *
You should only select one program. One Awana Registration per form.
Clubber Shirt Size
You should only select one shirt size. One Awana Registration per form.
Emergency Contact *
If Parent/Guardian is unreachable please contact the following person (name and phone number)
We want to create a safe and welcoming environment where every child can thrive. How can we best support your child's participation in Awana?
To help us provide a welcoming and supportive environment, please let us know about any physical limitations, medical conditions, or disabilities. Please also describe any accommodations or modifications that would be helpful for your child to participate fully in our program.
Participation Waiver *
TO WHOM IT MAY CONCERN: As a parent and/or guardian, I understand that participation in Awana involves risk of sickness, bodily injury, death, emotional injury, personal injury, property damage and financial damage. As a parent and/or guardian, I accept responsibility for all risks associated with my childās participation in First Baptist Childrenās ministry programs and agree not to hold First Baptist Church, its Board, Staff or Volunteers responsible for illness or injury sustained during Awana activities. To the best of my knowledge my child is healthy and free of symptoms indicating illness in order to participate in these childrenās ministries activities. As a parent and/or guardian, I do here with authorize treatment under the direction of any licensed physician of the following minor(s) in the event of a medical emergency which, in the opinion of the attending physician, may endanger his or her life, cause disfigurement, physical impairment, or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me by phone at the number provided above. The undersigned assumes the responsibility for any costs connected with such treatment and hereby releases the church where child(ren) attends Awana Club from any liability therefore. This release form is completed and signed of my own free will with the sole purpose of authorizing medical treatment under emergency circumstances in my absence.
Photo Permission *
Indicate below if First Baptist Church of Allegan has permission to post my childās/children's picture or video on the church website and/or The First Baptist Church of Allegan Facebook page. I understand that my childās/children's name will not be used in conjunction with his or her picture. I agree to hold First Baptist Church of Allegan, its officers, employees, the photographer, and volunteers free and harmless from all claims and liability relating to said photos when used with in the scope described above. *These permissions will remain in effect until otherwise notified. You may revoke this permission at any time by calling the church office.
Parent/Guardian's Electronic Signature agreeing to the terms above. *
By typing my name below I agree and understand that by signing below that all electronic signatures in this document are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.
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