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AWANA Registration

Community Bible Church AWANA Registration

Enrollment Form

Parent/Guardian #1 Phone

Email (Primary Contact)

Parent/Guardian  #2 Phone

Email

Street Address:  City:   State: Zip Code: 

People Authorized to Pick Up Child(ren):

 
 
Church Currently Attending:
 

Children's Information

Child #1

Nick Name:  Friend Request: 

Has your child been to AWANA before:  Last Awana Book Completed (if Known) 

Sex: Age:   DOB (mm/dd/yyyy):  Grade:  

Other Information (i.e.medical, behavior, or other issues):
 
 

Child #2: 

Nick Name:  Friend Request: 

Has your child been to AWANA before:  Last Awana Book Completed (if Known) 

Sex: Age:   DOB (mm/dd/yyyy):  Grade:  

Other Information (i.e.medical, behavior, or other issues):
 

 Child #3: 

Nick Name:  Friend Request: 

Has your child been to AWANA before:  Last Awana Book Completed (if Known) 

Sex: Age:   DOB (mm/dd/yyyy):  Grade:  

Other Information (i.e.medical, behavior, or other issues):
 
 

AWANA Photography Policy:

During the course of the AWANA year, we will be taking pictures of your children during regular club nights as well as special events. Some of the images will be posted for club publicity purposes (i.e., on our bulletin boards, year-end slide show, Facebook and/or CBC's website, promotional videos). Images will only be used by Community Bible's AWANA program and will not be released to any other entity. Children's names will not appear with photos except on the Book Finishers bulletin board where we will post first names only. 

Photo Option:  you must change this to NO if you would not like us to use photographs your child(ren).

Community Bible Church Medical Release:

As the Parent/Guardian, I do hereby authorize Community Bible Church to call an emergency ambulance in case of accident or acute illness, and to arrange for necessary emergency medical and surgical care in case I am not available. If the physician listed below is not available, any qualified physician called by Community Bible Church may treat or do whatever is necessary for the health and well being of this child. It is understood that every conscience effort must be made to notify parents/guardian before such action is taken. I agree to accept responsibility for payment of the above medical services. I also release Community Bible Church, other organizations, and individuals involved of any liability for accidents incurred during any of the AWANA club activities. 

Physician:  Phone #:  

Dentist:  Phone #: 

In case of emergency call: (Please list a friend or neighbor to call if the parent/guardian cannot be reached)

Name: Phone #: Relationship:

Name:Phone #:  Relationship:

This release form will be used during the entire year, September-April.  The document is applicable to both regular club meetings and outings (i.e., AWANA Games, Sparks-a-Rama, Sparky Hike, Field Trips, etc.).

TYPE OUT Your Complete Name as a Signature:

Dated:  Relationship to Child(ren): 

  
You will now be directed to the CBC online store for payment.