AWANA Registration

Child's Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Age

Grade

Birthday

YYYY

Select Shirt Size

Allergies

Yes

Allergies/Medications/Special Concerns

Parent/Guardian Name

First Name

Last Name

Parent/Guardian Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian Phone Number

(###)

###

####

Parent/Guadian Email

Emergency Contact Person & Number

Relationship to Child

Photo Permission

I give my permission for any "AWANA" pictures that include my child to be used on Fellowship Baptist Church's website and Facebook pace.

Yes

Waiver/Release

I, the parent/guardian, do herby grant permission for my child, named on form, to be accepted for all activities to be held by Fellowship Baptist Church. I do hereby release, forever discharge and agree to hold harmless Fellowship Baptist Church at 3741 Fohl St SW of Canton, OH; its pastors, directors, Awana leaders and youth leaders from any and all liability, claims or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by me and the child participant that occur while said child is participation in the above described activities. Furthermore, I hereby assume all risk of personal injury, sickness, death, damage and expenses as a result of my child's participation in recreation and work activities involved therein.

AWANA Registration

WORSHIP SERVICES:

Sundays

Wednesdays