Sonrise Church - AWANA Pre-Registration

AWANA Pre-Registration (Cost is $35 per clubber)

Club:

Clubber's Name:

Grade:

Gender:
Male
Female

Clubber's Age:

Clubber's Birthdate:

Address 1:

Address 2:

Country:

City:

State:

Zip/Postal Code:

Parent/Guardian Names:

Primary Phone Number:

Email

Church presently attending:

Alternative Contact:

Alternate Contact Name:

Alternative Contact Phone Number:

Medical and Insurance Information:

Physician Name:

Physician Phone Number:

Insurance Carrier:

Policy/Group/ID Number:

Allergy, Medical Conditions:

AWANA pick-up authorization

(Please include you, any other parent/guardian, and friends/family that you would like permission to pick up your clubber.)

The following people are authorized to pick my clubber up from AWANA:

Authorized Person #1:

Relation to Clubber:

Phone Number:

Authorized Person #2:

Relation to Clubber:

Phone Number:

Authorized Person #3:

Relation to Clubber:

Phone Number:

Authorized Person #4:

Relation to Clubber:

Phone Number:

Authorized Person #5:

Relation to Clubber:

Phone Number:

AWANA Pre-Registration (Cost is $35 per clubber)

Alternative Contact:

Medical and Insurance Information:

AWANA pick-up authorization

(Please include you, any other parent/guardian, and friends/family that you would like permission to pick up your clubber.)

The following people are authorized to pick my clubber up from AWANA:

Note: Required release forms to be signed on the clubber's first night of club to complete registration.