AWANA Clubs Registration Form | Maplesville Baptist Church

Parent or Legal Guardian's Name (Required)

Parent or Guardian

Your Mailing Address

Your Phone Number (Required)

Email Address (Required)

Child's Name (Required)

Emergency Contact and Phone Number

In the event of an emergency, who do we contact? Phone number?

Allergies or Medical Info

Are there any food allergies, skin allergies or respiratory allergies that your child has that might cause an emergency?

Child's Grade / Age (Required)

Child's Birthday (Required)

Do you give permission for the child's image to appear in photographs or videos used in social media or advertisements? (Required)

I have read and agree with the Maplesville Baptist Church Awana Policy

Signature

By typing your name here you agree to be bound by your electronic signature.

Solve 3 + 3 = ?

Maplesville Baptist Church