541-481-9437 rick@boardmanchurch.org

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2024-25 AWANA Registration Form

Parent / Guardian Name

First Last

Email

Address

Street Address Address Line 2

Phone

Alternate Phone

Emergency Contact Person

First Last

Relationship to Student

Emergency Contact Person Phone

Consent

Consent and Release

I give consent for my child/children listed below to attend the Awana program sponsored by Boardman First Baptist Church for the 2020/2021 school year. I understand the nature of active club meetings and do hereby release Boardman First Baptist Church and its representatives from any liability due to accident or injury incurred by my child.

Signature

First Child Information

1st Child's Name

First Last

Age

Grade

Birthdate

MM slash DD slash YYYY

Shirt size

small

medium

large

x-large

xx-large

Food Allergies

Yes

No

If Food Allergy, please list:

Medical Concerns:

Yes

No

If yes to Medical Concern, please identify:

Second Child Information

2nd Child's Name

First Last

Age

Grade

Birthdate

MM slash DD slash YYYY

Shirt size

small

medium

large

x-large

xx-large

Food Allergies

Yes

No

If Food Allergy, please list:

Medical Concerns:

Yes

No

If yes to Medical Concern, please identify:

Third Child Information

3rd Child's Name

First Last

Age

Grade

Birthdate

MM slash DD slash YYYY

Shirt size

small

medium

large

x-large

xx-large

Food Allergies

Yes

No

If Food Allergy, please list:

Medical Concerns:

Yes

No

If yes to Medical Concern, please identify:

Church Affiliation:

Person who may pick up the child(ren):

First Last

2nd Person who may pick up the child(ren):

First Last

I am interested in volunteering

Yes

No

Need Financial Assistance

Call

Email

Please have the commander or pastor contact me about financial assistance for our AWANA participation.

The fee for AWANA is $35 per child up to 3 children. 4 or more is the same as paying for 3 ($105). You may pay at the door, or pay online. We are asking you to cover the transaction fee for online payments (because our margin is very close too actual costs). Please select you preferred payment approach below.

AWANA Registration fee(s)

Price:

Quantity

Total

Payment plan

Credit Card

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Visual Verse of the Day

"I lift up my eyes to the mountains—where does my help come from? My help comes from the LORD..." Psalm 121:1

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