AWANA Form

REGISTRATION AND PERMISSION FORM
Community Evangelical Free Church
110 E Main Ave, Soap Lake, WA 98851
Church Phone: (509) 246-1147
Website: www.communitychurchsl.com

Dear Parent,

Please fill out this Registration and Permission Form and click Submit below. You will be required to sign it on your first club night.
Registration dues of $30.00 for the year will be paid for by Community Evangelical Free Church.
There is no charge to your family (except to replace lost items).

* Indicates required field

First Child Name *

First

Last

Gender *

Boy Girl

Age *

Birthdate *

School *

Food Allergies or Restrictions *

2nd Child Name *

First

Last

2nd Child Gender *

Boy Girl

2nd Child Age *

2nd Child Birthdate *

2nd Child School *

2nd Child Food Allergies or Restrictions *

3rd Child Name *

First

Last

3rd Child Gender *

Boy Girl

3rd Child Age *

3rd Child Birthdate *

3rd Child School *

3rd Child Food Allergies or Restrictions *

Parents (or Legal Guardians) *

First

Last

Home Church (if applicable) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone Number *

Cell Phone *

Email *

Emergency contact person if parents cannot be reached:

Emergency Contact Name *

First

Last

Emergency Contact Phone Number *

Emergency Contact Relationship to child(ren) *

Physician *

Physician Phone Number *

You will be required to sign the following permission statement when you bring your child(ren) for the first time:

I hereby give permission for my child(ren), named above, to attend and participate in Community Evangelical Free Church’s Awana Club and any special activities and events planned by the Awana Club. I do herewith authorize emergency treatment be given, if necessary, and only after a reasonable effort has been made to reach us/me the parent(s) or guardian. I the undersigned do hereby release and agree to hold harmless the Awana Leadership, Community Evangelical Free Church, and Awana Clubs International from any and all liabilities or claims for personal injury or illness which may be incurred by my child while attending and participating in the Awana Club and its activities and special events.

Parent/Guardian Signature *

Date *

PARENT/GUARDIAN AUTHORIZATION

Choose one of the following: *

I DO NOT authorize anyone to pick up my child(ren) except myself. I do hereby authorize the following person(s) to pick up my child(ren) listed above from AWANA:

Authorized pickup person *

First

Last

Relationship to child(ren) *

2nd Authorized Pickup Person *

First

Last

2nd Authorized Person relationship to child(ren) *

3rd Authorized Pickup Person *

First

Last

3rd Authorized Person relationship to child(ren) *

Communication

We now have two ways to communicate important AWANA information to you. (For example, if AWANA must be cancelled due to weather or other circumstances. Or reminders such as, "Don't forget! Next Wednesday is crazy hair day.")

You may: 

Or, sign up to receive an automated phone call. (Please note: the automated calling system will only be used for AWANA notices or reminders and will be used sparingly! Also, you will be able to opt out at any time.)

Yes, I woould like to receive the automated phone calls for AWANA notices and reminders on my following phone number:

Phone Number to receive notices and reminders *

Submit