AWANA Registration

Please fill out our AWANA form for each child. You can add additional children after each submission.

Parents Name

Attending Church

Phone

Address

City

State

Zip

_________________________________________________________________________

Clubbers First Name

Clubbers Last Name

Date Of Birth

Gender:

Gender

Grade in School:

Grade in School

_________________________________________________________________________

Handbooks: All clubbers will need a new handbook each year. Check the one for the grade your clubber is in.

Handbook

Does the clubber need a uniform? Check any uniforms or accessories you would like to order.

Uniform

Uniform size, if needed. Check any uniforms or accessories you would like to order.

Uniform Size

_________________________________________________________________________

Name of Emergency Contact

Phone for Emergency Contact

Relationship

Physician’s Name

Physician’s Phone

Special Instructions

I hereby authorize the leaders of AWANA to act on my behalf when I cannot be contacted, IN CASE OF AN EMERGENCY, resulting in the need of medical attention for my son/daughter named above. I also agree to hold harmless the AWANA leadership and First Baptist Church of Silvis, IL, from any sickness, communicable disease, accidents, or injuries resulting from my child’s participation in its activities. Furthermore, I agree to reimburse First Baptist Church, Silvis, IL for all medical expenses.

Authorized agreement

Agree

I understand that photographs will be taken throughout the Club Year which may be used as part of the Parents and Awards Night slide presenttaion. I hereby give my permission for my child to be photographed for this purpose. I further understand that if I do not wish my child to be photographed, it is my responsibility to notify the Club Commander.

Photo agreement

Agree

Additional Information:
Each clubber will need a new handbook each year. Books are $13 for clubbers aged 3 years
through 8th Grade. High school books are $20.00.

Optional Items:
CUBBIES vests – $15.00 (Sizes 4 5 6 8 10)
Cubby Book Bag – $7.50
SPARKS vests – $15.00 (Sizes 6 8 10 12 14 16)
Sparks Book Bag- $7.50
TRUTH AND TRAINING CLUB Shirt- $20.00
3rd-4th Grade Sizes Y-S Y-M Y-L A-S A-M
5th-6th Grade Sizes Y-M Y-L A-S A-M A-L A-XL
Backpack- $ 15.00