AWANA Registration

AWANA Club Registration Form
This form must be fully completed for each child attending club.

* Indicates required field

Child's First Name *

Child's Last Name *

Street Address *

City *

Zip Code *

Home Phone *

Cell Phone *

Email *

Home Church *

Grade *

Age (must be 3 by Sept. 1) *

Gender *

Male Female

Date of Birth (MM/DD/YY) *

Medical Information

Parent/Legal Guardian Name *

Allergies, Illnesses, Other Conditions or type "None" *

Insurance Carrier and ID# *

Emergency Contact Name *

Emergency Contact Phone *

Medical and Liability Release *

As a parent and/or guardian, I do authorize treatment, under the direction of any licensed physician, for the above named minor in the event of a medical emergency, which in the opinion of the attending physician, would endanger his or her life. This authority is granted only after a reasonable effort has been made to reach me by phone at the number(s) listed above. I (we) are the parent(s) or legal guardian(s) of this participant, do release, forever discharge and agree to hold harmless Calvary Baptist Church AWANA Club and the directors/workers/volunteers thereof from any and all liability, claims or demands for personal injury, sickness or death, as well as property damages and expenses, of any nature whatsoever which may be incurred by the child participant that occur while said is participating in the Calvary Baptist Church Awana Club trips or activities. Furthermore, I on behalf of my child participant, assume all risk of personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved therein. Further, authorization and permission is given to Calvary Baptist Church Awana Club and the undersigned further agrees to hold harmless and indemnify Calvary Baptist Church Awana Club, its directors, staff and volunteers, for any liability sustained by said travel organizers as the result of negligent, willful or intentional acts of said participant, including expenses incurred.

Signature *

By pressing the register button below, I understand that I am electronically registering my child on today's date, and that I will be asked to sign this form in person on the first day of AWANA.

AWANA Club Registration FormThis form must be fully completed for each child attending club.

Medical Information

​In the beginning was the Word, and the Word was with God, and the Word was God. John 1:1

AWANA Club Registration Form
This form must be fully completed for each child attending club.

In the beginning was the Word, and the Word was with God, and the Word was God. John 1:1