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AWANA REGISTRATION FORM 2022-2023
Name of Guardian:
Relationship to Child:
Phone Number
Name of Guardian:
Relationship to Child:
Phone Number
Do you attend church?
Yes
No
Do you attend Cornerstone?
Yes
No
Name of Church (if other than cornerstone)
Emergency Contact 1:
Phone Number
Relationship to Child:
Emergency Contact 2:
Phone Number
Relationship to Child:
Name of Child 1:
Age:
Grade:
Gender:
Male
Female
Birthday:
Allergies (if none, state none) or Special Information (medications or activity restrictions):
Club:
Cubbies (3-PreK)
Sparks (K-2nd)
T&T (3rd-5th)
T-Shirt Size:
Small
Medium
Large
X-Large
XX-Large
XXX-Large
Name of Child 2:
Age:
Grade:
Gender:
Male
Female
Birthday:
Allergies (if none, state none) or Special Information (medications or activity restrictions):
Club:
Cubbies (3-PreK)
Sparks (K-2nd)
T&T (3rd-5th)
T-Shirts Size:
Small
Medium
Large
X-Large
XX-Large
XXX-Large
Name of Child 3:
Age:
Grade:
Gender:
Male
Female
Birthday:
Allergies (if none, state none) or Special Information (medications or activity restrictions):
Club:
Cubbies (3-Prek)
Sparks (K-2nd)
T&T (3rd-5th)
T-Shirt Size:
Small
Medium
Large
X-Large
XX-Large
XXX-Large
Name of Child 4:
Age:
Grade:
Gender:
Male
Female
Birthday:
Allergies (if none, state none) or Special Information (medications or activity restrictions):
Club:
Cubbies (3-Prek)
Sparks (K-2nd)
T&T (3rd-5th)
T-Shirt Sizes:
Small
Medium
Large
X-Large
XX-Large
XXX-Large
1) I consent to and approve my child's taking part in any and all activities conducted by AWANA and/or CORNERSTONE BAPTIST CHURCH ("CHURCH"), which activities may include off- property excursions. I also understand that participation in this activity may include automobile transportation. I release, hold harmless and indemnify AWANA and the CHURCH, their respective agents, employees, volunteers, officers, and directors from any and all liability, costs, and claims arising from my child's participation in AWANA and the CHURCH. 2) I consent to the treatment of any minor injuries of my child and release, hold harmless and indemnify AWANA and the CHURCH and their officers, directors, agents, employees, and volunteers from any and all liability, claims and costs arising from or growing out of such treatment. 3) I hereby grant Cornerstone Baptist Church AWANA Club the right to copyright, reproduce, publish, and otherwise use my child's photograph in any and all media, for purposes of advertising and promoting Cornerstone Baptist Church AWANA Club. I hereby waive any causes of action I may have because of the use of my child's photograph and/or name. (Type your name below to agree)
Payment Method ($30 per child):
(Choose One)
I will pay online through the give tab
Cash
Check
Submit