Fremont Alliance Church - AWANA Registration

SUNDAYS:
9:15 & 10:45 - WORSHIP
8:15 - EARLY CLASS
9:15 - SS BEGINS (8/22)
10:15 - COFFEE
10:45 - KID'S CHURCH

WEDNESDAYS:
6:30 – AWANA (Sept)
6:30 – ONE80
6:45 - PARENT CLASS

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WELCOME to AWANA Online Registration

or use the
Registration Form

   Child's Name

   Address of Child

City & Zip Code of Child

Birthday of Child

Grade of Child

Home Church of Child

Contact in Case of Emergency

1^st Emergency Contact Name

Phone (that can be reached during club time)

  2^nd Emergency Contact Name


Phone (that can be reached during club time)

Medical Information
Date of Last Tetanus Shot

Specific Medical Allergies,
Chronic Illness or other Conditions

How did you hear about AWANA?

Your signature below (and date) will serve as a release form for your child (please read below).

Name of Parent or Gardian (Signature)

Relationship

Phone

E-mail

Date

Thank you for registering for AWANA!
NOTE: Space may be limited. The AWANA commanders will attempt to confirm all registrations the first night.

To whom it May Concern: As the parent or guardian, I do herewith authorize the treatment by a qualified and licensed medical doctor of the following minor in the event of a medical emergency which in the opinion of the attending physician may endanger the life, cause disfigurement, physical impairment or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me. The undersigned does hereby release and agree to hold harmless Fremont Alliance Church, AWANA Clubs and AWANA Clubs International, and their directors, employees, agents, or representatives from any and all liabilities or claims for personal injury, illness or death, as well as property damage and expenses of any nature whatsoever which may be incurred by our (my) son/daughter that occur on the above date stated and/or while said child is participating in the above named camp program and its activities. This release is intended to be used during the entire year, September 2010 through May 2011. This includes both club meetings and outings (i.e. AWANA Games, Sparks-a-Rama, Club Hikes etc.) This release form is completed and signed of my own free will.