2024-2025 Awana Club For Kids Registration Form

Our Awana Year will consist of two 8-week semesters
Semester 1: October 2, 2024-November 20, 2024
Semester 2: March 19, 2025-May 7, 2025

Our Awana Club meets on Wednesdays from 6:00 PM-7:15 PM and is for children 3 years old-5th grade.

Awana Club Fees:
$10 Club Fee Per Semester (For All Children)
$10 Handbook Fee (For K-5th Clubbers)
Scholarships Are Available

For more information about Awana Clubs, click here: awana.org

Personal Information

Child's Name

Child's Birthdate

Gender

Current Grade Level

Preschool Kindergarten First Grade Second Grade Third Grade Fourth Grade Fifth Grade

School Attending

Address

Parent/Guardian (#1) Name

Parent/Guardian (#1) Phone

Parent/Guardian (#1) Email

This address will receive a confirmation email

Parent/Guardian (#2) Name

Parent/Guardian (#2) Phone

List any allergies or medical concerns we should be aware of here.

Are you members of Glenn View Baptist Church?

If not, would you like more information about GVBC? Yes! Please call me. No thanks, not right now.

Guest of:

If there is a friend that your child would like to be grouped with for Awana, please put their name here. We cannot guarantee that we will be able to give everyone their preference, but we can certainly try.

May we have permission to photograph your child?

Yes No

May we have your permission to use your child's photograph in church publications (but not on-line)?

Yes No

Medical Release Form

Family Doctor

Family Doctor Phone Number

Medical Insurance Company (If none, type in: None)

Policy # (If none, type in: None

Specific medical allergies, chronic illnesses or other conditions

Date of Last Tetanus Shot

Emergency Contact Name

Emergency Contact Number

Relation To Clubber

This release will be in effect for the Awana Club Year 2024-2025

Please read the following waiver:

As a parent and/or guardian, I do herewith give permission to GVBC leaders to administer general first aid (i.e. band aids, Neosporin, etc.) to the above mentioned participant(s).

I also authorize the treatment by qualified and licensed medical personnel of the above mentioned participant(s) in the event of a medical emergency which, in the opinion of the attending medical personnel, may endanger his/her life, cause disfigurement, physical impairment or undone discomfort if delayed.

By checking below, I indicate that I am willing to take full financial responsibility for any and all medical services rendered for the above named participant(s).

Checking below also indicates my willingness for my insurance company to be billed for any and all medical fees and service should they be needed and to release Glenn View Baptist Church, its employees, trustees, and volunteers from this liability.

Name of Minor

Do you agree with the above waiver?

Yes No

___________________________________________________
Parent/Guardian Signature

___________________________________________________
Date Signed

2024-2025 Awana Club For Kids Registration Form

Description

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