Awana Registration - Lolo Community Church

Student First Name:*

Student Last Name:*

Nickname:

Gender:

Male

Female

Home Church (If Applicable):

Would you like more information about this church?:

Yes

Allergies:

Medical Issues or Special Needs:

Birthdate:*

Grade Entering:*

Parent/Guardian Information

Parent First Name:*

Parent Last Name:*

Mailing Address:*

City*

State:*

Zip:*

Phone Number:*

Area Code

Phone Number

Alternative Pickup Phone:

Area Code

Phone Number

E-mail:*

Re-Enter Your E-mail:*

Medical Release:*

I give my permission for the Awana/Lolo Community Church staff to administer basic first aid to my child (named above) in the event of an injury. I understand that the Awana staff will contact emergency services in the event of a significant injury and all expenses for such emergency services will be paid by parent or guardian.

Photo Release: I hereby grant the above named church permission to copyright and use photographs/videos taken at Awana/Lolo Community Church of the minor designated above in any manner or form for any purpose lawful at any time. I waive any right that I may have to inspect or approve the finished product or written copy, that may be used in conjunction therewith, or the use to which it may be applied. This includes a closed Facebook group.*

Yes

Permission to Attend:*

I give permission for my child (named above) to attend Awana/Lolo Community Church. I understand that the information I give for this registration will only be used by the Awana hosting church.

Permission to Contact: I, the undersigned, give permission for any Awana/Lolo Community Church members to contact my child by written communications or phone calls to discuss club activities. Praying with child and prayer requests. (Including birthday card, Christmas card and letters of encouragement.)*

Yes

We offer Van services for children 6 years old or weighing more than 60 pounds that would NOT make it to Awana otherwise. For the safety of Cubbies we want parents to drive their Cubbies. If you have any questions about this please email Sarah at loloawana@gmail.com or call her 406-360-7995. Thank you!

Does your child need Van services?*

Yes

Transportation Release: By marking YES in this section, I give permission for my child to ride in either a Lolo Community Church Van or Bus, to and from the church and our specific drop off/pick up location during any given AWANA night or Lolo Community Church activity:*

Yes

Pick Up Location:

Drop Off Location:

Typing your name constitutes your signature and acceptance of the terms of your releases:*

Print, fill out and bring the Cost Form to the first day of AWANA!