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Awana Registration Form

Pre-registration for the 2011-12 Awana year has begun. A registration form, including medical release, must be submitted for each child for the new year. You may register your child now using our convenient online registration form (below).

To register your child now (age two through sixth grade) for Awana, please complete and submit the following form (please submit a separate form for each child):

Child's Full Name:


Gender: Male    Female

Current Age:


Birth Date (xx-xx-xxxx):


School Grade (Fall 2010):


Parent(s) or Guardian(s):


Street Address:


City, State and Zip Code:


Home Phone (including area code):


Cell Phone (including area code):


Home Email Address:


Emergency Contact Person (name AND phone number):


Known Allergies:


Additional Medical Information:


Church You Attend:


Clothing Size:


PERMISSION AND MEDICAL RELEASE (REQUIRED)

YES, I /We give permission for my/our child to attend Awana Club at First Baptist Church of Joelton, TN for the duration of the current club year. I / We further give permission for my/our clubber's Awana leader to contact him/her via the phone or through the mail as it pertains to club functions or concerns. I / We also give permission for photos of my/our child to be used in church media and promotional materials. (NOTE: This box must be checked in order for your child to participate.)

IN CASE OF EMERGENCY - It is the policy of First Baptist Church Joelton, in the case of illness, accident or other emergency affecting any boy or girl attending a church function or activity, to make reasonable attempt to promptly contact the parent or guardian. It is required that inidicate

YES, I / We do hereby authorize First Baptist Church Joelton, its representative, to select transportation to their chosen licensed physician who may use upon and administer to the said child while attending him/her: x-ray examination, anesthetic, medical; or surgical diagnosis or treatment, order injections, or hospitalize, as in the opinion of such physician is deemed necessary or advisable.(NOTE: This box must be checked in order for your child to participate.)

VERIFICATION (TO PROTECT AGAINST FORM SPAM):

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