2018-2019 AWANA REGISTRATION - Cubbies/Sparks are no longer accepting Registrations for 2018-2019

Parent/Guardian Infomation

Parent/ Guardian 1 (First Name, Last Name)

Parent/ Guardian 2 (First Name, Last Name)

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Address

Phone Parent 1

Phone Parent 2

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This address will receive a confirmation email

Home Church (if none, please indicate)

Emergency Contact Name (First Name, Last Name)

Emergency Contact Number

Childs Information

Childs Name

Birthdate DD-MM-YYYY

Gender

Health Care Number

Grade Entering PreK K ! 2 3 4 5 6

Club Group Cubbies Sparks Truth & Training

Medical (allergies)

Please identify any food or medical issues we should be aware of .

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Medical Release

• *As a parent and/or guardian, I do herewith authorize treatment under the direction of any licensed physician of the minor(s) registered above in the event of a medical emergency which, in the opinion of the attending physician, may endanger his or her life, cause disfigurement, physical impairment, or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me. • *The undersigned assumes the responsibility for any cost connected with such treatment and I understand that the activities at this event can pose risks to personal health and safety I hereby agree to release Glen Elm Church, of Christ and its staff and volunteers from liability in the event of Injury. • A copy of this authorization can be used as the original. This form is completed and signed of my own free will with the sole purpose of authorizing medical treatment under emergency circumstances in my absence.

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Parent/Guardian Name (First Name, Last Name)

Photographs

Pictures are sometimes taken of children's ministry activities for promotional purposes, which include, but are not limited to, in-house presentations, church websites, brochures, and newsletters. Children's names/information are never used without specific permission. Please indicate below if you are allowing Glen Elm Church of Christ to use photographs of your child as stated above.

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Photographs Yes No

Dismissal

Please list any additional people who are authorized to pick up your child from AWANA activities: (This must be an authorized adult as we cannot release a child to a minor sibling.)

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Additional Adult (first Name, Last Name)

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Phone Number:

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Relationship

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Additional Adult (first Name, Last Name)

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Phone Number:

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Relationship

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Tips for club information and help with ordering

• Cubbies Club - ages 3 and 4, Cubbies must be toilet trained and able to stay on their own (Currently attending Glen Elm only) • Sparks Club - Kindergarten through Grade 2 • T&T Club - Grade 3 - Grade 6 IMPORTANT: All Clubs have a uniform and book. If your child is new to a particular club they will need a book and uniform. If your child is returning to the same club, you do not need to order a new uniform. Once they have completed their entrance booklets they will receive their uniform and book bag (If new) and books as they progress. If uniforms/books are lost it will be the responsibility of the family to replace/purchase the lost items at the current club prices. Uniforms should be ordered in a size that will allow the child room for growth as they should generally last most children for the duration of their specific club level.

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FEES & ORDERING for REGISTRATION

Registration Fee per child $30 Maximum per household $100 . Payment can be made by cash or cheque. E-transfer is available upon request. All cheques should be made payable to Regina Church of Christ. Forms must be comleted prior to attending.

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Annual Club Payment

Guests who become clubbers must have forms and fees paid by end of the second week of attendance. No awards, books, uniforrms etc., will be given prior to fees being paid, with the exception of Entrance Booklets. Please contact Bonnie @ 306-757-1825 or bonnie@warmwelcome.ca if you require any additional information or special arrangements.

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2018-2019 AWANA REGISTRATION - Cubbies/Sparks are no longer accepting Registrations for 2018-2019

Description

Please Fix the Following