Awana Registration 2024-2025 • First Alliance Church Toccoa

AWANA REGISTRATION FOR 2024-2025

Welcome! We're glad your child is here. Please complete the fields below to help us get to know your family better and ensure your child's well-being. Your information will not be used for other purposes and will not be shared with outside parties.

Child First Name *

Gender *

School Grade *

Child's Club

Tip: Note: Depending on registrations and available team members, we may not have Puggles. In that case, potty trained 3 year olds will be part of Cubbies, and non-potty trained 2-3 year olds will be part of Nursery.

Child Last Name *

Date of Birth *

Allergy/Medical Condition *

Tip: Include any special needs. If none, type NONE.

Family Information

Primary Guardian Name *

Tip: This is the parent/guardian you want us to have primary communication with

Email 1 *

Tip: An email you check regularly where we can send AWANA updates

Mobile Number *

I'm interested in being a Parent Partner

Yes

Secondary Guardian

Secondary Guardian Mobile Number

Mailing Address

Mailing State

Mailing City

Mailing Zip Code

Church Family Attends Regularly, if any

Safety Information & Consent

Emergency Contact *

Tip: Please include a person other than primary guardians

Emergency Contact Phone *

Pick-Up

We are thrilled to have your child in AWANA at First Alliance Church Toccoa. Because you hand over responsibility of your child to us, we take steps to be intentional to see that your child is safely returned to you at the end of the evening. With this in mind, First Alliance Church has set the following release policy:

Team Members will not release a child to a teenager or adult without complete certainty that the parents or parents representative is receiving the child.

Again, we will not release your child to an older brother/sister or any other individual without first receiving your permission. Therefore, please list below the names of people who have permission to pick your child up at the end of AWANA, whether to their homes or to another section of the church. Once your child has been released to you or your authorized representative, First Alliance Church is no longer responsible to monitor your child for safety and security.

Please do not drop your child off any earlier than 6:15pm and pick them up no later than 8:15pm so our team members can clean up and go home. We ask for your cooperation in not allowing your child to go to the Family Life Center (FLC) where youth group is taking place, and that your child not run around the parking lot where cars are or climb on railings.

Pick-Up Authorization *

Authorized Representatives for Pick-Up

Tip: We will only release your child to authorized individuals. Is there anyone other than you who may pick up your child today? Note that even if they are authorized, they will still need to present the claim tag at pick-up.

Medical Release Authorization

As a parent and/or legal guardian, I do herewith authorize treatment under the direction of any licensed physician of the above named minor in the event of a medical emergency, which in the opinion of the attending physician, may endanger his/her life, cause disfigurement, physical impairment, or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to contact parent/guardian by telephone at the numbers given above.

As a parent/guardian, I assume full responsibility for any cost connected with such treatment and hereby release the church where the child attends AWANA Club and all of the leaders of the club from liability.

Further, if there are specific treatment steps I wish First Alliance Church and its agents to take in response to any allergy, medical issues, or special needs, I must communicate those using a Special Needs & Medical Agreeement form.

This form is completed and submitted of my own free will with the sole purpose of authorizing emergency medical treatment of my child in my absence.

Medical Release Authorization *

Yes

Photo/Video Consent

Please be aware that from time to time photos and/or videos will be captured during First Alliance Church Toccoa events and ministries. These images may be used on FACT's website, Facebook, posters, email, slideshows, and other internal and external media. Your consent on behalf of yourself and your minor child is automatic unless you indicate otherwise. Please indicate below if you DO NOT wish for images of your minor child to be used. Please note that any images used, whether still or video, will not include names or other personally identifying information.

Photo/Video Consent

DO NOT Consent

Signature

Typing your name serves as your signature and indicates that you have read this form and completed this form accurately and thoroughly.

Your Name

Date