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Child Information

Child's Name *

First

Last

Home Address *

Line 1

Line 2

City

State

Zip Code

Country

Gender *

Birthday *

Age *

Grade *

Parent/Guardian Information

Child lives with... *

Father's Name *

First

Last

Cell Number *

Email *

Mother's Name *

First

Last

Cell Number *

Email *

Emergency Contact Information

Name *

First

Last

Relationship to Child *

Cell Number *

Email *

Any Special Concerns? *

Registration Fees + Optional Item Information

Awana provides an age-appropriate class for your child to learn the Scriptures and have fun with kids their age. The registration fee covers the cost of a book, awards your child earns, and weekly activity costs for your child.
Please check which class your child will be registering for and then select any optional items you would like for your child.

Choose One *

Puggles, 2 year olds ($5 Registration) Cubbies, 3-4 year olds ($20 Registration) Sparks, K-2nd grade ($20 Registration) T&T, 3rd-5th grade ($20 Registration)

NOTE: Most awards earned are placed on a vest

Shirt/Vest Size (If Ordered) *

Liability Release And Emergency Treatment Agreement

My child has my permission to attend Awana 2022/23 hosted by Villa Baptist Church and held at Central Christian Academy in Indianapolis, IN on Wednesdays from 6:45-8:15 pm.

I UNDERSTAND AND DO HEREBY AGREE TO ASSUME ALL OF THE RISKS AND OTHER RELATED RISKS WHICH MAY BE ENCOUNTERED BY MY CHILD PARTICIPATING IN AWANA.

The Undersigned hereby release and forever discharges Villa Baptist Church, its staff, adult leaders, and any other persons, who it might be claimed to be liable. None of whom admit any liability from any and all claims, demands, actions, causes of action or suits of any kind or nature whatsoever and particularly on account of all injuries known and unknown, both to person and property, which have resulted or may in the future develop from any accident which might occur as a result of joining AWANA sponsored by Villa Baptist Church.

I further state that I HAVE CAREFULLY READ THE FORGOING RELEASE AND KNOWN THE CONTENTS THEREOF AND AM SIGNING THIS RELEASE AS AN ACT OF MY OWN FREE WILL. This is a legally binding agreement which I have read and understand.

Full Name of Legal Guardian *

First

Last

Date Signed *

Photo Release

I, the undersigned, do hereby grant or deny permission to Villa Baptist Church to use the image of my child, as marked by my selection(s) below. Such use includes the display, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of my child for use in materials that include, but may not be limited to, printed materials, videos, and digital images.

Photo Release (Choose One) *

Deny Permission Grant Permission

Full Name of Legal Guardian *

First

Last

Date Signed *

Permission to Travel Off-Site

On rare occasions, our older students have special reward nights that take place at a nearby restaurant (i.e. McDonald's or Dairy Queen). Please indicate whether you grant or deny permission for your child to leave Central Christian Academy with their classmates and leader for these reward nights.

Travel Permission *

Deny Permission Grant Permission

Full Name of Legal Guardian *

Date Signed *

Sign Up for Awana!

Child Information

Parent/Guardian Information

Emergency Contact Information

Registration Fees + Optional Item Information

Liability Release And Emergency Treatment Agreement

Photo Release

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