Oakhurst Evangelical Free Church AWANA CHILD REGISTRATION FORM 2024-2025 Awana Child RegistrationParent(s) Name*Email* Day Phone*Cell PhoneMailing Address*Home ChurchNumber of Children Being Registered*Please enter a value between 1 and 5.Register ClubbersClubber Name*Birthday* Grade*Gender*Please list any: Medical Conditions, Activity Restrictions, Drug/Food/Other Allergies:*Clubber NameBirthday GradeGenderPlease list any: Medical Conditions, Activity Restrictions, Drug/Food/Other Allergies:Clubber NameBirthday GradeGenderPlease list any: Medical Conditions, Activity Restrictions, Drug/Food/Other Allergies:Clubber NameBirthday GradeGenderPlease list any: Medical Conditions, Activity Restrictions, Drug/Food/Other Allergies:Clubber NameBirthday GradeGenderPlease list any: Medical Conditions, Activity Restrictions, Drug/Food/Other Allergies:Emergency ContactIn case of an emergency and the parent or guardian cannot be reached, who would be contacted?Primary Contact Name*Relationship to Child*Address*Phone*Secondary Contact NameRelationship to ChildAddressPhoneMedical InformationMedical Insurance CarrierPolicy #Acceptance and CommentsWe hereby release the Oakhurst Evangelical Free Church and the above mentioned AWANA Clubs Program and/or AWANA Clubs leaders from liability in case of injury or illness to the above named Child(ren). The above named child(ren) has my permission to participate in the activities in the above named AWANA Clubs Program. In the event that I/we cannot be reached in the event of an emergency, I give my permission for necessary medical care, to secure proper treatment and to order injections, anesthesia or surgery for the above named child(ren). I understand that all billings for service not billed to my insurance carrier will be billed to me as a parent/guardian.PHOTO RELEASE: I hereby grant to Oakhurst Evangelical Free Church and to its employees, agents and assigns the right to photograph me or my dependent and to use the photo and or other digital reproduction of him/her to other reproduction of his/her physical likeness for publication processes, whether electronic, print, digital, or electronic publishing via the internet.* I understand and agree to the above terms of service. Δ This iframe contains the logic required to handle AJAX powered Gravity Forms.
