Awana Registration

AWANA PROGRAM REGISTRATION FORM

Name of participant: * (Please fill out one form for each child.)

Grade going into this fall: *

Address and City: *

Birthdate:

Name of Parent/Guardian: *

Phone#: *

Alternate Phone #:

Email: *

I represent and promise the child identified above has my permission to attend VBC’s Awana Program and participate in all activities. TYPE "YES" IF YOU AGREE *

In event of any illness/injury, I give consent to any/ all medical treatment or hospital care as deemed necessary for the welfare of my child. It is understood that the resulting expenses will be the responsibility of the Parent/Guardian. I, the undersigned, hereby release and discharge Vassar Baptist Church, its officers, employees, agents, lay leaders, property owners, and volunteers from all liability arising out of or in connection with the Awana program. TYPE "YES" IF YOU AGREE *

Medical / Allergy Concerns

Note: Fields marked with * are required