Awana Puggles 2022 • Battlefield Baptist Church

Our Puggles Club is for Children Ages 2-3

A child must be 2 years of age by 10/1/22 to register for this Club

First Name *

Last Name *

Age *

Date of Birth *

Gender *

Parent Name *

Email Address *

Phone Number *

Mobile Number *

Home Address *

Home City *

Home State *

Home Zip Code *

Has your child ever been a part of an Awana Club in the past? *

Yes

If so, where?

Does your family regularly attend church? *

Yes

If so, where?

T-Shirt Size *

Because of the size and nature of the Awana Ministry here at Battlefield Baptist Church, we require a PARENT OR LEGAL GUARDIAN to REMAIN ON CAMPUS for the duration of each club night for ALL PRESCHOOL-AGE CHILDREN. This policy is for the safety and security of your children in case of an emergency. Agreement to adhere to this policy is REQUIRED to register your child for the Awana Ministry at Battlefield Baptist Church.

Electronic Signature *

I give permission for my child to participate in all activities associated with the Awana Bible Club at Battlefield Baptist Church during the 2022-2023 school year. I waive all claims against Battlefield Baptist Church and/or leadership, including Club Directors and Club volunteers, of any injuries that may be sustained by our said minor child and agree to indemnify and hold the church and workers free and blameless from any liability, costs, and damages therefore. I hereby consent to and grant the leadership of Battlefield Baptist Church full rights and authority to act for me in any manner pertaining to the care and control of the said minor child named above during the Awana Club year (2022-2023). Additionally, I grant Battlefield Baptist Church leaders my consent to obtain medical assistance that may be required for this said minor child during this Club year (2022-2023) as deemed necessary. I agree to accept complete financial responsibility for the costs related to this emergency medical treatment.

As a result of the continued spread of COVID-19, Battlefield Baptist Church will continue to use caution and protocols to help reduce the spread of COVID-19; however, the Ministry cannot guarantee that you or your family, including your child(ren), will not become exposed to or infected with COVID-19. By signing this waiver, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected with COVID-19 in connection with my child(ren)’s attendance and participation in Awana.

Electronic Signature *

Current Date *

Medical Insurance Company *

Medical Insurance Identification Number *

List allergies, if any:

List medications, if any:

Date of last tetanus shot *

Does this child have any special problems, conditions, or restrictions? *

Yes

If yes, please explain:

Please list any special instructions: