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Child's Information
Name *
Name
Date of Birth *
Date of Birth
Gender *
Please be specific and request a form if medications are being left onsite with the child. If none, please say NONE.
Club *
Parent or Guardian Information
Name *
Name
Relationship to the child *
Others Authorized to pick up child
Must be 18 years or older
Person 1
Person 1
Person 2
Person 2
Contact Information
Address *
Address
Phone *
Phone
Other
Do you have a church home? *
Please Specify:
ARE YOU INTERESTED IN BEING A LEADER? *
Leaders must be a Christian in a personal, growing relationship with Jesus. Leaders must have an attractive attitude to children and must be in compliance with church requirements by completing Plan to Protect.
PHOTO RELEASE *
I give permission for me and my child's picture or any photographic/video footage to be used for identification for security or in other Evangel promotional materials. By checking "YES" I acknowledge that these photographs will be stored on Evangel hard drives for these purposes.
WAIVER *
While ever precaution is taken for safety and good health for our AWANA clubbers by ensuring good ratios of leaders to clubbers and carefully planning games and activities, some sports and activities carry with them the inherent risk of personal injury (beyond the risk associated with many of the recreational activities at Evangel). I understand and accept these risks and agree that by allowing my child to participate in AWANA and AWANA game time, my child may be taking part in a recreational activity that presents the potential for personal injury. I undertake and agree to indemnify and hold blameless Evangel, its personnel, its leaders and Board from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Evangel, as well as any medical treatments authorized by the supervising individuals representing Evangel. By checking "YES" I understand and agree with the above information.
Club Fees are $75 payable to "Evangel" with "AWANA" in the memo.
Fees include all materials required - handbooks and uniform. please note that returning clubbers will continue to use the uniforms from previous years until they are transitioning clubs. Refunds for withdrawals will not be issued. should you withdrawal, your fees will be used towards supporting the AWANA program and cover fees for those who cannot afford registration.
The purpose and extent of this registration form is for Evangel to collect and retain your personal information for the purpose of enrolling your child in our programs, to assign them to the appropriate classes, to develop and nurture ongoing relationships with you and your child, and to inform you of program updates and upcoming opportunities at our church. The information you have provided will be maintained confidentially and indefinitely as it is a requirement of our insurance company and legal counsel. If you wish for Evangel to limit the information collected, or to view your child's information, please contact us.