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AWANA 2020-2021 Registration on Thursday, September 10, 2020

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** Attendee above should be the child,  not the parent **
140.00 
140.00 
140.00 
140.00 
115.00 
1- 
1- 
1- 
1- 
1- 
   
110.00 
   
110.00 
120.00 
   
112.00 
112.00 
116.00 
Handbook (if ordered above):
Uniform Size (if ordered above):
*Child's Gender:
*Child's Date of Birth:
*Child's Age:
*Child's Grade (Fall 2020):
Allergies or Special Instructions for Child:
*Mom's Name:
*Dad's Name:
*Mom's Cell Phone:
*Dad's Cell Phone:
Alternate Email:
*Local Church You Attend:
If you are able to help with a club, please tell us which club. Click here to submit your volunteer application if you have not already been approved.
In consideration for being accepted by Liberty Baptist Church for participants in the AWANA Program, I do hereby release, forever discharge and agree to hold harmless Liberty Baptist Church of Hampton, Virginia and the trustees thereof from any and all liability, claims or demands for personal injury, sickness or death, as well as property damage and expenses fo any nature whatsoever which may be incurred by the undersigned and the participant that occur while said person is participating in the above-described activity including recreation and work activities. The undersigned further hereby agrees to hold harmless and indemnify Liberty Baptist Church, its trustees, employees and agents for any liability sustained by said acts of said participant, including expenses and agents for any liability sustained by said acts of said participant, including expenses incurred attendant thereto. The undersigned further consents to the administration of first aid or doctor's care of any other form of medical treatment by illness or injury that may require the same. In the event of the necessity of such care or treatment as heretofore described, the undersigned agrees to hold harmless and indemnify Liberty Baptist Church, its trustees, employees and agents from any acts of malfeasance, and/or failure to act on the part of those chosen to administer medical care on behalf of the participant.
*Please type Parent's Name as signature of agreement to the above statement:
*Insurance Number and Policy Number:
*Contact name and phone number in case of Emergency:
Please click here to complete this liability form, print, and bring it with you when you attend AWANA.
If you are registering more than three children, please contact the church office for a discount promo code