Awana Registration Form

Name

This address will receive a confirmation email

Phone

Address

Authorize Guardians & Emergency Contact Information:

Please List Anyone Who CANNOT Pick up your Child:

Kids Information: First and Last Name, Age, Birthday, Grade for 2024-2025, Uniform Need (Yes/No and Size if needed) Book Needed (Yes/No): PLEASE LIST ALL INFORMATION FOR ALL KIDS

Medical Information: Allergies, medicines, special needs etc. Please also list primary healthcare provider if applicable:

Terms & Conditions:

I understand my child will participate in physical activities in game time during Club. I fully accept this risk and hold harmless from any legal liability, Christian Life Fellowship church and any persons involved in the Awana Club Ministry. If I/we cannot be reached, I give my permission to the AWANA staff to secure the appropriate care necessary for my child's well being. I assume responsibility for all costs connected to any accident or treatment. I grant permission for general club photos as long as there is no identifying information shown. I grant permission for my child to travel to/from Awana club events with an adult leader. Any such event will be clearly communicated with me beforehand. I have read and agree to the Terms and Conditions stated above.

All payments go toward your child's book, uniform, awards, patches, and other activities. These monies are non-refundable.

I Need Payment Plan

Yes No

Payment Options($80 is the family maximum. If you have more than 4 kids, still select that payment option).

Date

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Awana Registration Form

Description

Please Fix the Following