Awana Registration

Parent Information

Parent's Full Name*

Parent's Phone Number*

Parent's Email Address*

Enter Email Confirm Email

Emergency Contact Information

Emergency Contact Name*

If we are not able to reach you at the phone number you provided, who should we contact in the case of an emergency?

Emergency Contact Phone Number*

Child's Information

How Many Children Would You Like to Register?*

First Child's Full Name*

First Child's Age (As of September 1, 2017)*

First Child's Grade*

Shirt Sizes

Each age group will get their own amazing shirts. If your child is in the 3&4 year old group, choose the Cubbies size. If they are in Kindergarten - 2nd Grade, choose the Sparks size. If they are in 3rd-6th grade, choose T&T or adult. Thanks!

First Child's Shirt Size*

Second Child's Full Name*

Second Child's Age (As of September 1, 2017)*

Second Child's Grade*

Second Child's Shirt Size*

Third Child's Full Name*

Third Child's Age (As of September 1, 2017)*

Third Child's Grade*

Third Child's Shirt Size*

Fourth Child's Full Name*

Fourth Child's Age (As of September 1, 2017)*

Fourth Child's Grade*

Fourth Child's Shirt Size*

Fifth Child's Full Name*

Fifth Child's Age (As of September 1, 2017)*

Fifth Child's Grade*

Fifth Child's Shirt Size*

Sixth Child's Full Name*

Sixth Child's Age (As of September 1, 2017)*

Sixth Child's Grade*

Sixth Child's Shirt Size*

Seventh Child's Full Name*

Seventh Child's Age (As of September 1, 2017)*

Seventh Child's Grade*

Seventh Child's Shirt Size*

Do Any of the Children Have Medical Conditions or Allergies That We Need to be Aware Of?*

Yes
No

If yes, please explain in the next question.

Please list any allergies or medical conditions that we need to be aware of.

Be sure to include which child(ren) these apply to.

Permission to Participate

As parent/guardian of the above named minor(s), I hereby grant permission for my daughter/son to participate in Westside Church of Christ’s Awana program, held at 7300 Stockdale Hwy Bakersfield, California from now until September 1, 2018. I have discussed the event with my daughter/son, and s/he agrees to abide by the rules of the event. I understand my daughter/son will be sent home if s/he is unable to behave within the rules of this event. I also give permission for my child's photograph to be used for slideshows and promotional materials at the sole discretion of Westside Church of Christ.

I have read and agree to the "Permission to Participate" listed above.*

I Agree

Medical Authorization

As the parent / guardian of the above named minor(s), I also grant permission for any adult chaperone with Westside Church of Christ to take whatever steps may be necessary to obtain emergency care as warranted for the well being of my daughter/son. These steps may include but are not limited to the following: - Attempts to contact a parent or guardian - Seek medical examination/treatment for injuries/condition by medical professional. This will be in effect from now until September 1, 2018.

I have read and agree to the "Medical Authorization" listed above.*

I Agree

Release of Liability

I agree that all activities are undertaken by the minor at the sole risk of the Minor(s) and myself, and that the Westside Church of Christ, the owners of the Property, and any other adult chaperones shall not be liable for any claims for injuries or damages whatsoever to person or property of the Minor(s) or myself arising out of or connected with the event or arising out of the use of the Property from now until September 1, 2018. I further agree to indemnify and to hold the Westside Church of Christ, the owners of the Property and any other adult chaperone assisting with the event harmless from all claims by or liability to Minor(s) and myself and hereby absolve them from any responsibility for personal injuries and/or property loss arising out of the event.

I have read and agree to the "Release of LIability" listed above.*

I Agree

Today's Date*