Parent Name *

First Name

Last Name

Child's Name *

First Name

Last Name

Club Registering for: *

Cubbies (3-5 yr old - MUST be potty trained AND 2 years before entering Kindergarten)

Sparks (K-2nd grade)

T&T (3rd - 6th grade)

Child Number 2

First Name

Last Name

Club Registering for

Cubbies (3-5 yr old - MUST be potty trained AND 2 years before entering Kindergarten)

Sparks (K-2nd grade)

T&T (3rd - 6th grade)

Child Number 3

First Name

Last Name

Club Registering for

Cubbies (3-5 yr old - MUST be potty trained AND 2 years before entering Kindergarten)

Sparks (K-2nd grade)

T&T (3rd - 6th grade)

Photo Release *

The AWANA program provides many great photo and video opportunities of our clubbers. We would like your permission to use images taken of your child/children during AWANA internally in classrooms and hallways and in print or electronic promotional materials. Children will not be identified by name when photos are used for publicity purposes, no compensation will be offered for any images. By indicating yes below, you give permission for electronic or photographic images of your children to be used by Grace Church in its print or electronic media.

Yes

No