AWANA Clubs 2024-2025
Please fill out this form and click submit.
Clubber Information
Child's Name
*
Age/Grade
*
Please select one option.
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
3 yrs.
4 yrs.
5 yrs. (Not yet in kindergarten)
Birthdate
*
Gender
*
Please select one option.
Male
Female
Address
*
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Parent Information
Parent Name(s)
*
Parent's Email
*
This address will receive a confirmation email
Parent's Phone Number
*
Emergency Contact (other than parents) and phone number
*
Persons (other than parents) authorized to pick up children
Please list any allergies or medical conditions that we should be aware of.
1) I understand that my child/children may participate in physical activities such as those held during Game Time. As with any physical activity, there is a risk of injury. I fully accept this risk and hold harmless from any legal liability, Sterling Wood Church and any persons involved in the Awana Club ministry. 2) As a parent/guardian, I give permission to Sterling Wood Church's staff, volunteers and/or group sponsors to provide medical treatment that may deemed necessary to insure the well-being of the above named student(s). In the event of an emergency that requires medical treatment for the above named child/children, I understand every effort will be made to contact me or my emergency contact. However, if I/we cannot be reached, I give my permission to the AWANA volunteers to secure the services of a licensed physician to provide the care necessary for my child's well being. I assume responsibility for all costs connected to any accident or treatment of my child. This release is complete and signed of my free will with the sole purpose of authorizing medical treatment under emergency circumstances in my absence. 3) This release also covers all Sterling Wood Church activities, outings, and photo releases from September 2024 thru September 2025.
*
Please select all that apply.
By checking this box, I agree to the Terms and Conditions stated above.
Submit
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