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Aside AWANA Registration Awanas Registration If you are human, leave this field blank. Registration/Medical Release Form (For club meetings and all supervised Awana outings) Bethel Baptist Church, Fredericksburg, VA (540) 371-3650 Club Cubbies (3-4 yrs) K-Sparks 1st-2nd Sparks T&T Girls (3rd-5th) T&T Boys (3rd-5th) Is this a transfer from another church? Yes No Name of church transferring from (Please provide proof of completed books.) Clubber's Legal Name First, Middle, Last Nickname Gender * M F Date of Birth Age: Grade: School: Family Church: Clubber's email: Home Phone: Parent's email: Home Address: Number & Street, City, Zip Code Mailing Address (if different): P.O. Box or Street, City, Zip Code PARENT / GUARDIAN / FAMILY INFORMATION Father Father Guardian Father's Name: First, Last Father's Home Phone * Father's Cell Phone Father LIVING WITH CLUBBER? Yes No Mother Mother Guardian Mother's Name: First, Last Mother's Home Phone Mother's Cell Phone Mother LIVING WITH CLUBBER? Yes No Emergency Contact Information: In case I/we cannot be reached during an emergency, I/we the undersigned give permission for my/our child to be treated by a a licensed physician if this emergency might endanger his/her life and/or cause disfigurement, physical impairment or undue discomfort by delaying treatment. Said physician is to administer whatever care is necessary, including anesthesia. The undersigned assumes responsibility for any costs connected with such treatment and hereby releases Awana Clubs International, Bethel Baptist Church of Fredericksburg, Virginia and the driver of any vehicle transporting my child to a supervised Awana outing, from liability. This release form is completed and signed of my/our own free will and with the sole purpose of authorizing medical treatment under emergency circumstances in my/our absence. Emergency Contact #1 Name: Emergency Contact #1 Relationship: Emergency Contact #1 Phone Number: Emergency Contact #2 Name: Emergency Contact #2 Relationship: Emergency Contact #2 Phone Number:
VBS Registration Form July 6, 2017 Vacation Bible School – Registration Form VBS Registration Form If you are human, leave this field blank. Child's Name Parent/Guardian Name Address (street address, city, state, and zip code) Mailing Address (if different) Phone Numbers Home Work Cell Email Address Age Information Birth Date Last grade completed in school Medical Information Medical or other information we need to know. (Please include any food allergies.) Emergency Contacts (other than listed above) Name Phone Number Name Phone Number Dismissal Information Who may pick up your child at the end of each VBS day? Other Information Does your child attend Sunday School? If so where? If your child is visiting our church, who is he a guest of? May we have permission to photograph your child? Yes No May we have permission to use your child’s photograph for the purpose of promotion? Yes No Vacation Bible School – Adult Registration Form Adult Registration Form If you are human, leave this field blank. Name Address (street address, city, state, and zip code) Mailing Address (if different) Phone Numbers Home Work Cell Email Address Other Information Do you attend Sunday School? If so where? Are you a church member? If so, where? If you are visiting our church, who are you a guest of? May we have permission to photograph you? Yes No May we have permission to use your photograph for the purpose of promotion? Yes No
