Bethel Evangelical Church - AWANA Registration

AWANA Registration 2024-25

First Name

Last Name

Phone Number

Phone Number Phone number where you can be reached while your child is at Awana:

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Home Church

For safety reasons, children may not be unsupervised in the church parking lot. Parents, please pick up your children inside (or at the door) of the church after Awana.

The following people are allowed to pick up my children:

Emergency contact/phone number:

Name of Family Physician

Phone number of Physician

I would like to...

Help with AWANA

Supply Snacks

Bring a meal for athletes coming straight from sports

Optional free-will donation. Registration fee is not required. Donations are voluntary and appreciated. Awana costs approximately $40-$50 per child for books, uniform, and awards. There will be a cost to replace lost books/uniforms. * Please make checks payable to: Bethel Evangelical Church and indicate "Awana" on memo line.

Child First Name

Child Last Name

Birthdate

Age of Child

Grade

Health, or behavioral concerns:

Specific food/medical allergies

Special Needs or Disability:

PARENTAL CONSENT FOR AWANA PARTICIPATION AND AUTHORIZATION FOR EMERGENCY CARE TO A MINOR

To whom it may concern:

I do hereby grant permission for my child(ren) to participate in all aspects of the Awana Program at Bethel Evangelical Church.

I understand and give permission for my child(ren) to participate in the Awana program and games, photographs and video, and give emergency medical release.

• I give permission for my child(ren) to be included in physical games that are structured and supervised, while understanding that physical injury and/or illness is possible with unforeseen circumstances.

I understand that, in the event medical treatment is required, every effort will be made to contact me; however, if I cannot be reached, I give permission to the staff or leader to secure the services of a licensed physician to provide the care necessary, including anesthesia, for my child's well-being.

I also understand that I am responsible for the cost of professional medical emergency care.

• I give permission for Bethel Evangelical Church to use photographs and/or video of my child(ren) for publicity purposes, including on the church website and social media.

• I give permission for my child(ren) to ride in any vehicle driven by an approved licensed adult chaperone while attending and participating in activities sponsored by Bethel Evangelical Church.

My child(ren) and I understand that without exception, seat belts will be worn at all times.

My child(ren) and I understand that without exception, seat belts will be worn at all times.

This release form is completed and signed of my own free will with the purpose of authorizing medical treatment under emergency circumstances in my absence for the Awana Club year, September 1, 2024, through April 30, 2025.

Signature

Date Input