AWANA Registration

Participant Information

Child's Name

Child's Age

Child's Gender

Male Female

Child's Date of Birth

Allergies or Other Medical/Behavioral Needs

Yes No

If you selected 'Yes' please list those allergies, medical, or behavioral needs

Parent/Guardian's Name

This address will receive a confirmation email

Phone

Address

Does your family regularly attend a church? If yes, please include the name of your church.

Emergency Contact Information

Please list two additional people that can be contacted in case of emergency if the parent/guardian listed above cannot be reached.

Name

Phone

Relationship to the child

Name

Phone

Relationship to the child

Safety Information and Consent

Check-In System

Memorial Baptist Church uses an electronic check-in system that prints each child a name tag and each parent/guardian a reciept tag. The parent/guardian tag must be presented at the time of pick up for the safety of the child.

Photo and Video Consent

Be advised that there will be photography and videography during AWANA - some of this content will be posted to the church's social media accounts and website. By attending AWANA, you grant permission for Memorial Baptist to post content containing your child to our social media accounts and website.

Safety Information and Consent

I understand and consent

Authorized Pick Up Persons (list the names of people authorized to pick up your child/children).

Follow Up Questions

Would you like Memorial Baptist to follow up with you about future children's ministry events and information about the church?

Yes No

Comments or Questions

AWANA Registration

Description

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