Lenexa Baptist - Register Clubber

Welcome to online registration

New Awana Registration

Household Information

Parent/Guardian #1 *

Relationship

Parent/Guardian #2

Relationship

Address *

City *

State *

Zip *

Enter alternate address for Parent/Guardian#2

Phone# *

Other Emergency Contacts (include phone numbers)

Please include a phone# and name for each of your Other Emergency Contacts.

List others authorized to pickup your child

What church do you attend?

Church attendance is NOT required. Enter NONE if you don't attend a church.

Website Login

Email *

Alternate Email

New password *

Please enter a password you'd like to use to login to this site.

Clubber Information

First Name*

Last Name*

Gender*

Grade for 2024-25*

Birthdate*

Invited by

Special Notes

Please enter any special notes that we should know about your child. For example, allergies, special instructions, etc.

AUTHORIZATION AND RELEASE OF LIABILITY: I, the parent or guardian of the above-named child/children, understand that my child/children may participate in physical activities such as those held during Game Time. As with any physical activity, there is a risk of injury. I fully accept this risk and hold harmless from any legal liability, Lenexa Baptist Church and any persons involved in the Awana Club ministry.

YES, I consent to the above

In lieu of your signature, please enter your initials:

Medical Conditions: In the event of an emergency that requires medical treatment for the above named child/children, I understand every effort will be made to contact me or my emergency contact. However, if I/we cannot be reached, I give my permission to the Awana volunteers to secure the services of a licensed physician to provide the care necessary for my child's well being. I assume responsibility for all costs connected to any accident or treatment of my child.

YES, I give permission as stated above for my child regarding medical care

In lieu of your signature, please enter your initials:

Photo Release: Photographs are sometimes taken of Awana ministry activities for publicity and promotional purposes, which include, but are not limited to, in-house presentations, church web site, brochures and newsletters. By signing below, you are granting the church to use photographs of the above mentioned minor(s) as stated as long as there is no identifying information shown.

YES, I grant permission for use of photographs of my child as stated above

NO, I do NOT authorize use of photographs of my child

In lieu of your signature, please enter your initials:

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