AWANA Volunteer Registration "*" indicates required fields Step 1 of 6 16% Contact InformationName* First Last Email* Enter Email Confirm Email Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender* Male Female Church you attend* Primary Phone*Primary Phone is a:*Cell PhoneWork PhoneHome PhoneOtherAre you willing to receive SMS Messages (Text Messages)?*Note: Standard Text Messaging Rates Apply. Yes No Area of MinistryGrade & Department requests are subject to approval. Please note: Requests are not guaranteed. I am interested in working with the following group:Check all that apply. I'm happy to help in any group with a need! Cubbies (Ages 3-5) Sparks (Kinder-2nd) T&T (3rd - 5th) Trek (6th-8th) Journey (9th-12th) My second choice would be to serve:Check all that apply. I'm happy to help in any group with a need! Cubbies (Ages 3-5) Sparks (Kinder-2nd) T&T (3rd-5th) Trek (6th-8th) Journey (9th-12th) I'd like to help in this way: Additional notes or limitations on how I can best serve (including schedule limitations): Medical InformationAllergies / Disabilities / MedicationsHealth Insurance Provider ID / Policy # Phone Number of Medical Center / PhysicianPhysician's Name Emergency ContactName* First Last Phone*Relationship* Authorization & Liability WaiverBy checking the boxes on this electronic form you are agreeing to these written terms and conditions.I, the undersigned, acknowledge my participation in, and/or give permission for, volunteering and activities for AWANA provided by Long Beach Alliance Church September, 2024–June, 2025. I, the undersigned, confirm I am legally 18 years or older and sign on behalf of myself.* Yes, I confirm and agree with these terms, and am signing this acknowledgement voluntarily. I grant my permission to fully participate in Long Beach Alliance Church AWANA events and activities. These activities include, but are not limited to, being transported in church, chartered, and chaperone vehicles to and from event destination(s); swimming in off-site pools; competitive and strenuous group games; ice skating; inflatable obstacle courses, inflatable toys; lifeguard monitored beach swimming and activities; swings and playground equipment; water balloon games; squirt gun and water spraying activities, and large group Earthball, and volleyball competitions. I understand that I may be photographed or videotaped during activities and that these photos/videos may be used in promotional materials published by Long Beach Alliance Church.* I hereby certify that I have read and clearly understand these terms and that this authorization/waiver/covenant is being executed voluntarily. I understand the Long Beach Alliance Church AWANA staff, volunteers, and leaders will make every attempt to contact my emergency contact as soon as possible in the event an emergency arises. If contact cannot be made, I authorize the Long Beach Alliance Church staff, AWANA volunteers, and leaders to provide medical care, and if necessary, transport me to a doctor or medical facility. I also authorize medical treatment recommended by medical staff and I assume responsibility for all medical costs.* I hereby certify that I have read and clearly understand these terms and that this authorization/waiver/covenant is being executed voluntarily. I, on behalf of myself, my children, my assigns, and my estate, assume the risk and promise to release from liability and hold harmless for personal injury or sickness and/or damage to personal or public property resulting from my participation, Long Beach Alliance Church, its officers, Governing Board, Elders, agents, employees, and/or volunteers for any and all claims for injuries, causes of action, or liability related to my participation in any Long Beach Alliance Church AWANA onsite or offsite activity. This release does not apply to intentional and/or willful acts of misconduct by Long Beach Alliance Church or any of its officers, Governing Board, Elders, agents, employees, and/or volunteers. I agree to indemnify and hold harmless the Long Beach Alliance Church, its officers, Governing Board, Elders, agents, employees, and/or volunteers for any liability incurred or property damage/loss sustained by Long Beach Alliance Church as the result of the negligent, willful, or intentional conduct of myself, including expenses attendant thereto.* I hereby certify that I have read and clearly understand these terms and that this authorization/waiver/covenant is being executed voluntarily. Volunteer T-ShirtAWANA Uniform Size* Adult S Adult M Adult L Adult XL Adult XXL Adult 3XL Note: Your email confirmation will include further instructions to complete the volunteer process. Δ