2018-2019 AWANA Clubs of Christ First Registration

Welcome! We're excited to begin the 2018-2019 AWANA Clubs of Christ First Church! We can't wait to have an awesome time learning and growing in Christ.

Meetings begin October 7th, 2018 and go through April 28th, 2019. Meetings will be held Sunday nights from 5pm-7pm (no club meetings on 11/25/18-12/30/18, 2/3/19, 4/21/19. Meetings may be canceled due to unforeseen circumstances such as inclement weather).

There is a registration fee of $15 per child. If you're having problems with registering your child please call (815) 475-7101, or email us at christfirstinfo@gmail.com

Parent/Guardian Name

Address

Phone #

Emergency Contact Name

Emergency Contact Phone #

1st Child's Full Name

Age/School Grade

List any Allergies

Child's Primary Physician Name

Primary Physician's Phone #

2nd Child's Full Name

Age/School Grade

List any Allergies

Child's Primary Physician Name (If different than listed above)

Child's Primary Physician's Phone Number (If different than listed above)

3rd Child's Full Name

Age/School Grade

List any Allergies

Child's Primary Physician Name (If different than listed above)

Child's Primary Physician's Phone Number (If different than listed above)

4th Child's Full Name

Age/School Grade

List any Allergies

Child's Primary Physician Name (If different than listed above)

Child's Primary Physician's Phone Number (If different than listed above)

Option

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Being the legal guardian of the minor(s) named herein, I give permission for the minor(s) to attend and participate in all AWANA sponsored events, activities, and outings, sponsored by Christ First Baptist Church between October 7, 2018 and April 28, 2019 and relieve Christ First Baptist Church of all liability in the event of an accident. I hereby give Christ First Baptist Church and/or its sponsors the authority to secure any medical and/or surgical treatment for the minor(s) that is determined necessary in the event of an emergency, sickness, or accident. I shall be liable and agree to pay all costs and expenses incurred in connection with all medical and dental services rendered to the aforementioned minor pursuant to this authorization. Should it be necessary for the minor(s) to return home due to medical reason(s) or otherwise, I shall assume all transportation costs. I give permission for the minor(s’) picture to be used in church publications such as but not limited to: newsletters and the church’s website. All pictures used in church publications will not include the minor(s’) name or age.

YES

2018-2019 AWANA Clubs of Christ First Registration

Description

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