New Life Awana Family Information

Parent / Guardian Name(s):

Address:

Cell Phone Number:

Secondary Phone Number:

Email:

Emergency Contact (in the event we are unable to reach you):

Emergency Contact Name:

Emergency Contact Phone Number:

Relationship to Child:

Permission to Check-In / Check-Out (in addition to parents - must be at least 16 years old):

Photo & Media Permission

I give permission for photos & video to be used internally only (photo displays, slideshows, etc.):

Yes No

I give permission for photos & videoto be used publicly (church website & social media):

Yes No

Parent / Guardian E-Signature (By signing this document electronically, I agree that my electronic signature is the legal equiavalent of my manual/handwritten signature on this document. I represent and warrant that I am the minor's parent or legal guardian.):

Date of E-Signature:

Child 1:

Name:

Gender:

male female

Birthdate (month/day/year):

Grade for 2026-2027:

Allergies, Support Needs, & Special Instructions:

Need a new club bag? Yes No

Child 2:

Name:

Gender: male female

Birthdate (month/day/year):

Grade for 2026-2027:

Allergies, Support Needs, & Special Instructions:

Need a new club bag? Yes No

Child 3:

Name:

Gender: male female

Birthdate (month/day/year):

Grade for 2026-2027:

Allergies, Support Needs, & Special Instructions:

Need a new club bag? Yes No

Child 4:

Name:

Gender: male female

Birthdate (month/day/year):

Grade for 2026-2027:

Allergies, Support Needs, & Special Instructions:

Need a new club bag? Yes No

Child 5:

Name:

Gender: male female

Birthdate (month/day/year):

Grade for 2026-2027:

Allergies, Support Needs, & Special Instructions:

Need a new club bag? Yes No

Payment Options: Please pay below with a credit/debit card. We also accept cash or check (payable to New Life Church) upon check-in.

Payment - $20 per child

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Welcome to New Life Awana!

We are so happy you are a part of our Awana Family! We are looking forward to partnering with your family and making it a fun, meaningful year together!

Awana : Wednesday's from 6:30 - 8:00pm.
Check - In Begins at 6:15pm.

~Amanda Geiman
Awana Director

New Life Awana Family Information

Description

Please Fix the Following