Awana Registration

Awana Registration Form 2022-2023 - Maywood Evangelical Free Church

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Family name:

Address:

City, State and Zip Code:

Phone number:

Email address:

Name of Guardian or Parent:

Brought to Awana by:

Child First and Last Name:	Birthdate:	Grade in school:	Club level:

In allowing my child to participate, I give permission for Maywood E. Free Church to use my child’s image (no names) on their website for Ministry purposes.

By checking this box, I am indicating that I DO NOT GIVE Permission for my child’s image to be used.

Signed (parent or guardian):

IN CASE OF EMERGENCY

Although it is our sincere desire to provide a safe environment for our children, we also recognize that accidents can, and sometimes do, happen. If such a situation should occur, our first response will be to contact you, the parent, unless it is a life-threatening injury where it would be wise to seek immediate medical attention. The purpose of this form is to allow us to obtain first aid care for your children if we are unable to contact you.

MEDICAL CARE PERMISSION

I give permission for (children’s names):

to receive emergency medical treatment by professional medical personnel in the case of injury or illness while he/she is in the care of Maywood Evangelical Free Church during AWANA.

Signed:

Relation to child:

TELEPHONE NUMBERS

Mother's Name:

Home Phone: Work Phone: Cell Phone:

Father's Name:

Home Phone: Work Phone: Cell Phone:

Family Physician:

Phone:

Allergies per child:

Awana® and the Awana logo are trademarks of Awana Clubs International. Used by Permission.

Becoming a People to Reach People for Christ