Awana

Child's Name *

Gender *

Age *

Grade *

Date of Birth (mm/dd/yyyy) *

School attending *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Photo Release: I authorize my child to be photographed for the purposes of advertisement for Awana. *

Yes No

Name of Parent(s)/Guardian *

Parent/Guardian Cell Phone *

Home Phone *

Email *

Church you attend *

Allergies/Medical concerns *

Medical Release

In consideration for my children (listed above) being allowed to participate in the Awana Clubs, on behalf of my child, my spouse and myself, I hereby assume all risks in connection with Awana Clubs and I further release Lifeline Church, the Pastoral Staff, or Teachers thereof from all claims, judgments, liability for any injury or damage that the child or his/her estate, myself or my spouse ever had, now has or may have due to the child's participation in the Awana Clubs, including all risks connected therewith whether foreseen or unforeseen.(including health risks such as, but not limited to, COVID-19) I fully understand what is involved in Awana Clubs and I understand that I have the opportunity to call the church and/or Leader and ask him/her about the Awana Clubs.

Emergency Contact Name *

Phone Number *

Policy/Group number *

Relationship *

Health Insurance Company *

By selecting the box below you agree to the above medical release form. *

Agree to Medical Release Conditions

Awana Registration

Awana Registration Form

Medical Release

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