2026 Awana Clubs Registration Form

Clubber's Information

Name

Date of Birth

Age as of September 2026

2-3 (Puggles) 4-5 (Cubbies) 6-8 (Sparks) 9-11 (T&T) 12-14 (Trek)

Preferred Bible Version

NKJV (New King James Version) ESV (English Standard Version) NIV (New International Version) KJV (King James Version)

Parent or Guardian Information

Name

Phone

Address

Allergies/Sensitivities

Other Allergies or Special Needs

Emergency Contact/ Authorized for Clubber Pickup

Emergency Contact Name

Emergency Contact Phone Number

Permissions

I give my permission for my child's picture to be taken and used for social media.

Yes No

Medical Release Information

As a parent/ guardian, I do hereby authorize the treatment by a qualified and licensed medical doctor of the above minor in the event of a medical emergency which, in the opinion of the attending physician, may endanger his/ her life, cause disfigurement, or undue comfort if delayed. This authority is granted after all reasonable efforts have been made to reach me. I am agreeing to what is outlined in this release of my own free will with the sole purpose of authorizing medical treatment under emergency circumstances in my absence for the Awana Club.

Medical Permissions

I grant permissions

2026 Awana Clubs Registration Form

Description

Please Fix the Following