Awana Registration | Maysville Baptist Church

Address*

Parent/Guardian Name*

Relationship to Child *

Are you a member of Maysville Baptist Church?*

Yes

Would you like more information about Maysville Baptist Church?

Yes

Please select Club Age/Grade

Note, your child must be the appropriate age on or before September 1.

Check one:*

Puggles 2 yrs old (must be 2 by 9/1/17)

Cubbies 3 yrs old (must be 3 by 9/1/17)

Cubbies 4 years old

Sparks Kindergarten

Sparks 1st Grade

Sparks 2nd Grade

Truth & Training 3rd Grade

Truth & Training 4th Grade

Truth & Training 5th Grade

Has your child attended an Awana Club before?

Yes

Is your child a member of any church or Sunday School?

Yes

Has your child made a profession of faith in Jesus Christ?

Yes

Emergency Contact Information

Please list an Emergency Contact and their phone number below.

Is child allergic to tetanus shot?

Yes

Does your child have any medical alerts or allergies?*

Yes

Please list any known allergies or medical conditions:*

Permission Agreement

I, hereby, give permission for the child named above to participate in Awana Clubs at Maysville Baptist Church. I, the legal guardian of the above mentioned child, do hereby give permission to render emergency medical and or surgical treatment as may be necessary by this hospital/doctor facilty. I also accept full responsibility for medical expenses which are incurred for my child during Awana Clubs. Please note, in an event of an emergency we will contact the number that you provide as an emergency contact.