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AWANA Trek & Journey** on Monday, September 8, 2025 @ 6:30 PM

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Please complete all fields on this form, including the signature box at the bottom.
If optional uniform is wanted, what size? Please note that this uniform will be worn up through 12th grade, size accordingly. :
*Birthdate ie: mm/dd/yyyy:
*Grade in the Fall of 2025:
*Gender:
Food Restriction:
Other Concerns/Needs (Asthma, allergies, physical limitations, custody concerns, etc.):
Do you have a specific leader request?:
Does your child want to be placed with a specific friend?:
Mom's/Guardian's Name:
Mom's/Guardian 's Cell:
Dad's/Guardian Name:
Dad's/Guardian's Cell:
*Will a parent/guardian be volunteering in Awana?:
If so, where?:
*If no, a phone number where you can be reached during Awana:
*Name of church your family attends for weekend services:
Alternate Contact/Relationship:
Alternate Contact's Phone:
Authorization: I do hereby state that I have legal custody of the aforementioned minor. I grant my authorization and consent for Grace Baptist Church to administer general first aid treatment for any minor injuries or illnesses experienced by the minor. If the injury or illness is life threatening or in need of emergency treatment, I authorize Grace Baptist Church to summon any and all professional emergency personnel to attend, transport, and treat the minor.
Pictures may be taken during the event for church use. This form, when completed, may be printed and/or photocopied.
By typing my first and last name in this box, I am signifying that I am the parent or guardian for the child listed above and have the authority to enter into this agreement on their behalf
*Parent/Legal Guardian Signature:
*Today's Date:
:
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