AWANA REGISTRATION FORM

Wednesday Nights, beginning Sept. 4th | Please fill out one form for each child participating in AWANA and click submit.
AWANA Attender Information

AWANA dues are $20 per child. These fees are used to go towards your child's book, bag, AWANA store items, year-end awards, and special theme night surprises we have throughout the year. If registering in person on an AWANA night, fees are collected at that time.
A seperate form must be filled out for each child you are registering.
 
Please select all that apply.
 
Age or Grade Information

Please tell us what grade you will be in school for 2019-2020 school year. If you are not attending school, just mark your age. PRE-SCHOOLERS MUST BE COMPLETELY TOILET TRAINED IN ORDER TO PARTICIPATE IN CUBBIES, WHICH IS 2 YRS PRIOR TO KINDERGARTEN. Thank you for your understanding.
Please select one option.
Medical Info for Attender

Please select all that apply.
If you checked "yes" on allergies, please write in the box below the allergy specifics.
 
 
 
 
Please select all that apply.
 
 
 
 
 
Parent or Guardian Information

 
 
 
Please select one option.
 
 
 
 
 
 
 
 
 
Please select all that apply.
 
 
 
 
Medical Treatment Authorization

I understand that I will be notified in the case of a medical emergency. However, in the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event that my child is injured or becomes ill. I authorize one or more of the named persons above to make emergency medical care decisions on the behalf of my child, if required by law or a health care provider or another adult leader at Highland designated by the staff of Highland Baptist Church. I authorize these persons to act in my place to consent to all necessary and appropriate x-ray examinations, anesthetic, medical or surgical diagnosis or treatment, and hospital care, should I as parent/guardian not be available. I understand that Highland Baptist Church will not be responsible for medical expenses incurred solely on the basis of this authorization. I also understand that the designated adult leaders reserve the right to restrict my child from any activity that they do not feel is within the physical capabilities of my child.


I understand that Highland Baptist Church leaders cannot administer medications whether prescription or over the counter and if a medicine is needed, parent/guardian or emergency contact will be contacted to personally administer.

 
Children's Activity Consent

I, being the parent or legal guardian of the child named above, do hereby consent to the participation of my child in the following activity conducted by Highland Baptist Church.



I also certify that my child is physically fit and adequately prepared to participate in this event to the best of my knowledge.

 
Media Consent Release

This portion grants Highland Baptist Church the absolute right and permission to use photographic portraits, pictures, digital images or video of your child, or in which your child may be included in whole or part, or reproductions thereof in color or otherwise for public promotion, including but not limited to use in any Highland Baptist Church publication or on the Highland Baptist Church website, without payment or any other consideration.  
Please select all that apply.
 
AWANA Payment

$20
 
 
 
 
 
 

Description

Wednesday Nights, beginning Sept. 4th
Please fill out one form for each child participating in AWANA and click submit.