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Sunday Worship*:
8, 9:30 and 11am

Kid's Quest Children's
Classes & Adult
Bible Fellowships*:
8, 9:30 and 11am

* Nursery available
at all services

Prayer Meeting @ 7
5315 Douglas Road
Oswego, IL 60543
Phone: 630-554-3858
Fax: 630-554-3865
E-Mail Us

Awana 2007/2008 Registration

Please complete all fields below to enroll your child in the 2007/2008 Awana Program at Harvest Baptist Church.
CLUB ENROLLMENT
Club Enrollment:
CLUBBER INFORMATION
Clubber's Name:
Address:
Apt # :
City:
State:
Zip Code:
Home Phone:
Gender:
Male: | Female:
Age:
Birthdate:
 (mm/dd/yyyy)
Grade in Fall:
Guardian's Name:
E-Mail:
EMERGENCY INFORMATION
Emergency Contact Name:
Emergency Contact Phone:
Physician's Name:
Physician's Phone:
Medical Insurance Company:
Policy Number:
Allergies, medical conditions or special instructions:
What church do you attend?

EMERGENCY AUTHORIZATION

I hereby authorize the leaders of AWANA to act on my behalf when I cannot be contacted, IN CASE OF AN EMERGENCY, resulting in the need of medical attention for my son/daughter/ward named above.

I also agree to hold harmless the AWANA leadership and Harvest Baptist Church from any accidents as a result of my child's participation in its activities. My submission of this form also servers to indicate my willingness to take full financial responsibility for any and all medical services rendered for the above named participant. My submission also serves to indicate my willingness for my insurance company to be billed for any and all medical fees and services should they be needed.

I Agree | I Disagree

PHOTO RELEASE

If any photos are taken during the Awana Club activities, I give the church permission to do the following for non-profit use and without any charge: use at the discretion of the church, display at a service or event or be used in a multimedia presentation, reprint and distribute in any church non-profit publication with copyright to accompany photo when used (for eample: in brochures or church bulletins, ect.) or display on the church website.

I Agree | I Disagree
   
 

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