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AWANA Registration Form

PARENT/GUARDIAN NAME: *
PARENT/GUARDIAN NAME:
TELEPHONE: HOME
TELEPHONE: HOME
CELL:
CELL:
WORK:
WORK:
TELEPHONE:
TELEPHONE:
I permit or do not permit Second Baptist Church’s AWANA Club to use, in whole or in part, photographs, videos, written extractions and voice recordings of my child(ren) for the purpose of illustrations, publications, local newspapers and websites . Public relations information will never include my home address, telephone number or Social Security number *
Terms and Conditions: 1) I understand that my child/children may participate in physical activities during AWANA session and that, as with any physical activity, there is risk of injury. I fully accept this risk and hold harmless from any legal liability, Second Baptist Church and any persons involved in the AWANA ministry. 2) In the event of a medical or dental emergency that requires medical treatment for the above named child/children, I understand every effort will be made to contact me or my emergency contact. However, if I/we cannot be reached, I give my permission to the AWANA staff to secure the services of a licensed physician to provide the care necessary for my child’s well-being. I assume responsibility for all costs connected to any accident or treatment of my child. *
I authorize or do not authorize the Second Baptist Church’s AWANA Club leadership to share my personal information with the pertinent AWANA staff to ensure my child(ren)’s growth in the AWANA Club. *