Awana – Glenola Baptist Church

AWANA meets on Wednesdays from 6:00 – 8:00 pm for all children from age 2 through 6th grade.

AWANA Commanders: Deanna Bradley and Jen Durham

Register Your Children For Awana

Please use the below form to register.

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Name

First

Last

Age:

Age

Grade:

Grade

Birthday:

Birthday

Gender

Male
Female

Address

Address Line 1

Address Line 2

City

State

Zip Code

Parent/Guardian

Home Phone:

Home Phone

Cell Phone:

Cell Phone

Child's Known Allergies:

Allergies

Name of Physician

Physician

It is the policy of Glenola Baptist Church, in case of illness, accident, or other emergencies affecting a boy or girl attending AWANA or en route to or from an AWANA-sponsored activity, to make every reasonable attempt to get in touch promptly with the parent or guardian of such child. Since it is not always possible to reach you immediately, the parent or guardian of each child enrolled in AWANA is required to sign the following consent form to treat a minor:

I/We, the undersigned parent or guardian of Child's Name , a minor, do hereby authorize Glenola Baptist Church to select transportation to their chosen licensed physician or hospital for my child to receive medical treatment if an emergency arises.

Signature:

Signature

Date / Time

Date

Please list anyone other than parent/guardian who will pick your child up.

Name:

Name of Person 1

Phone #:

Phone Number of Person 1

Name:

Name of Person 2

Phone #:

Phone Number of Person 2

Name:

Name Of Person 3

Phone #

Phone Number of Person 3

Other Information

Do you attend church?

If so, where?

May we have permission to photograph your child for Awana events?