Awana Registration

2024 AWANA Student Registration

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Step 1 of 7

Parent's Information

Parent's Name (Primary)*

First Last

Parent's Name (Secondary)

First Last

Email*

Note: This is the email address through which all confirmations & notifications will be communicated.

Enter Email Confirm Email

Parent's Address (If different than Child's Address)

Street Address City State ZIP Code

Parent Primary Contact Number*

Parent Secondary Contact Number

May we contact you via SMS Messaging (Text Message)?*

Note: Standard text messaging rates apply

Yes

Medical Release, Waiver of Liability, & Indemnity Agreement

Only the child's parent or legal guardian may sign this release. Your signature is represented by checked boxes. Please read the following statement(s) carefully and check the boxes below. All minors are required to have a parent or guardian's signature to attend The Long Beach Alliance AWANA Program. By checking the boxes on this electronic form you are agreeing to these written terms and conditions.

I(we) the undersigned, acknowledge participation in, and/or give permission for, my(our) minor child to participate in AWANA provided by Long Beach Alliance Church September, 2024 - June, 2025. I(we) the undersigned confirm I(we) am(are) legally 18 years or older and sign on behalf of myself(ourselves) and on behalf of my(our) child.*

Yes, I confirm and agree with these terms, and am signing this acknowledgement voluntarily.

I(we) am(are) the parent(s) or legal guardian(s) of the minor listed above and grant my(our) permission for him/her to fully participate in Long Beach Alliance Church AWANA events and activities. These activities include, but are not limited to, competitive and strenuous group games; inflatable toys; swings and playground styled equipment; water balloon games; squirt gun and water spraying activities; food games; games played by crawling on floor; games played with balls, rackets, etc.; throwing or flying projectiles; and/or running. I(we) understand that my(our) child may be photographed or videotaped during activities and that these photos/videos may be used in promotional materials published by Long Beach Alliance Church.*

Yes, I confirm and agree with these terms, and am signing this acknowledgement voluntarily.

I(we) understand the Long Beach Alliance Church staff, volunteers, and AWANA leaders will make every attempt to contact me as soon as possible in the event an emergency arises. If contact cannot be made, I(we) authorize the Long Beach Alliance Church staff, volunteers, and AWANA leaders to provide medical care, and if necessary, take my child to a doctor or medical facility. I(we) also authorize medical treatment recommended by medical staff and I(we) assume responsibility for all medical costs.*

Yes, I confirm and agree with these terms, and am signing this acknowledgement voluntarily.

I(we), on behalf of my(our) child, 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(our) child’s 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 and/or my minor child’s 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, willful negligence, or lack of supervision by trained adult volunteer staff by Long Beach Alliance Church or any of its officers, Governing Board, Elders, agents, employees, and/or volunteers. I(we) 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 my child, including expenses attendant thereto.*

Yes, I confirm and agree with these terms, and am signing this acknowledgement voluntarily.

Register your child today!

2024 AWANA Student Registration

Child's Information

Parent's Information

Medical Information

Emergency Contact Information (Other Than Parent)

Medical Release, Waiver of Liability, & Indemnity Agreement

Cubbies Fees & Payments for Registration

Sparks Fees & Payments for Registration

T&T Fees & Payments for Registration

Trek Fees & Payments for Registration

Journey Fees & Payments for Registration

Total Fees

To Complete Registration

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