AWANA Registration | FIRST BAPTIST CHURCH

AWANA Registration 2018-2019

Child's Last Name

Child's First Name

Gender

Boy

Girl

Date of Birth

School Grade

Age

Allergy or Medical Conditions

Parent Or Legal Guardian Name

Address

Cell Phone 1

Cell Phone 2

Home Phone

Email Address

Church Attended

In Case Of Emergency When Parent/Guardian Cannot Be Reached Notify

Relationship To Child

Cell Phone

Home Phone

The following persons have permission to pick up my child from AWANA

Important Information: 1.) I consent to and approve my child(ren)’s taking part in any and all activities conducted by First Baptist Church Lawton AWANA Clubs. I understand that my child(ren) may participate in physical activities such as those held during game time. As with any physical activity, there is a risk of injury. I fully accept this risk and consent to the treatment of any minor injuries of my child(ren), and release, hold harmless and indemnify AWANA and First Baptist Church Lawton and their officers, directors, agents, employees and volunteers from any and all liability, claims and costs arising from or growing out of such treatment. In the event of an emergency that requires medical treatment for the above named child(ren), I understand every effort will be made to contact me or my emergency contact. However, if I/we cannot be reached, I give my permission to the AWANA volunteers to secure the services of a licensed physician to provide the care necessary for my child’s well being. I assume responsibility for all costs connected to any accident or treatment of my child. 2.) I understand that any off-property AWANA excursions will be communicated with me beforehand and I will be required to sign a separate medical release form in order for my child to participate in those excursions. I acknowledge that participation in AWANA has the following non-exclusive list of activities that bear risk and danger and from which bodily injury, up to and including mortal injury, may occur: transportation to and from various destinations; being outside or in the presence of inclement weather conditions including, but not limited to, lightning, wind and/or hail; contact with plants, animals, insects and/or other environmental hazards; or other unknown and unanticipated activities and risks. 3.) I give permission for photo(s) of my child(ren) to appear among other general club photos in any and all media as long as there is no identifying information published by First Baptist Church Lawton. I hereby waive any causes of action I may have because of the use of my child’s photograph. I have read and agree to the Terms and Conditions stated above.

Yes