AWANA Sparks Co-ed K-2nd Grade Registration Form 2018-19
 
AWANA Sparks Co-ed K-2nd Grade Registration Form 2018-19
Child's Last Name  * 
Child's First Name  * 
Boy or Girl (please make selection)  * 
Mailing Address (Street or PO Box)  * 
City  * 
State  * 
Zip Code  * 
Child's Birthdate i.e. (00/00/0000)  * 
Child's Age at time of Registration  * 
Child's Grade for 2018-19 School Year  * 
Does your child have any allergies? If none, please write none.  * 
Parents First & Last Name(s)  * 
Parents Cell Phone Numbers (Mom's & Dad's)  * 
Phone number or classroom where you can be reached during AWANA  * 
Secondary emergency Name & Phone Number  * 
Church You Attend - If none, please write none.  * 
Sparks Registration Fees:  * 
All handbooks are given to clubbers after completion of the entrance booklet.
You can have the optional Handbook Bag for $8.00. Please add it if you want it.  * 
If you cannot be reached in the event of an accident or emergency, do you authorize a church representative to make arrangements for your child to receive medical care?  * 
Do you fully release & hold harmless GRACEPOINT CHURCH, its volunteers & staff from all liability for any accident, injury or death caused in attendance at any AWANA activity?  * 
Do you grant GracePoint Church permission to electronically display your child’s picture on our new Facebook page?  * 
Do you authorize the physician named below to provide care and treatment for your child as deemed necessary in the event of an accident or medical emergency?  * 
Physician's Name & Phone Number  * 
Do you attest that adequate insurance is in effect to cover your son or daughter while attending all AWANA activities?  * 
Insurance Provider & Group/Health ID #  * 
Your Email Address  * 
Total $
 
 
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