AWANA Registration Form (2016-2017)
Ascension Lutheran Church, Waterloo, IA
*Class Begins September 7, 2016 * @ 6:15 – 7:30 * Cost - $30 *
Child 1:
Last Name ______First Name______Birthday ______
Grade ______Returning “Clubbers” only: Last book completed: ______
Allergies & Special Problems:______
Uniform size: Has Uniform Need Uniform (Please circle your size from the following choices.)
We recommend ordering a larger size because 1. Uniforms are much smaller than clothing of the same size. 2. Uniforms can be worn for more than one year. ** If your child needs another uniform, there will be an additional cost. **
Cubbies (3 to 4 years old) Small (4) Medium (5) Large (6) X-large (8) XX-large (10)
Sparks (K to 2nd grade) Size 6 Size 8 Size 10 Size 12 Size 14 Size 16
T&T (3rd 4th ) Youth Small Youth Med Youth Lg Adult small Adult medium
T&T (5th & 6th) Youth Small Youth Med Youth Lg Adult small Adult medium Adult L Adult XL
Child 2:
Last Name ______First Name______Birthday ______
Grade ______Returning “Clubbers” only: Last book completed: ______
Allergies & Special Problems:______
Uniform size: Has Uniform Need Uniform (Please circle your size from the following choices.)
We recommend ordering a larger size because 1. Uniforms are much smaller than clothing of the same size. 2. Uniforms can be worn for more than one year. ** If your child needs another uniform, there will be an additional cost. **
Cubbies (3 to 4 years old) Small (4) Medium (5) Large (6) X-large (8) XX-large (10)
Sparks (K to 2nd grade) Size 6 Size 8 Size 10 Size 12 Size 14 Size 16
T&T (3rd 4th ) Youth Small Youth Med Youth Lg Adult small Adult medium
T&T (5th & 6th) Youth Small Youth Med Youth Lg Adult small Adult medium Adult L Adult XL
Child 3:
Last Name ______First Name______Birthday ______
Grade ______Returning “Clubbers” only: Last book completed: ______
Allergies & Special Problems:______
Uniform size: Has Uniform Need Uniform (Please circle your size from the following choices.)
We recommend ordering a larger size because 1. Uniforms are much smaller than clothing of the same size. 2. Uniforms can be worn for more than one year. ** If your child needs another uniform, there will be an additional cost. **
Cubbies (3 to 4 years old) Small (4) Medium (5) Large (6) X-large (8) XX-large (10)
Sparks (K to 2nd grade) Size 6 Size 8 Size 10 Size 12 Size 14 Size 16
T&T (3rd 4th ) Youth Small Youth Med Youth Lg Adult small Adult medium
T&T (5th & 6th) Youth Small Youth Med Youth Lg Adult small Adult medium Adult L Adult XL
*** Please turn over and fill out family information. ***
Family Information: (for AWANA and Children’s ministries use only at Ascension)
Mother’s Name ______Father’s Name ______
Address: City: State: Zip:
Home Phone ______Mom’s cell ______Dad’s Cell ______
Email:
Who will regularly bring your child to club?
Where can the parent be found during club time if necessary?
If you are not a member of Ascension, do you attend a church? ______Name of Church:
Persons to be contacted, other than parents, in the event that the parents cannot be reached in
case of illness, accidents, discipline issues, etc.
Name & Phone: ______
Name & Phone: ______Doctor & Phone: ______
** Please let us know if there are any family circumstances that may affect who may pick up your child. **
The child(ren) listed have my permission to attend AWANA at Ascension Lutheran Church, from 6:15 pm. to 7:30 p.m. Wednesday evenings. I understand that I should be reachable by the AWANA leaders during the AWANA time. I understand I am responsible to get my child to club and pick them up promptly. I will watch the AWANA schedule and remind my child of appropriate uniform, items to bring, theme nights, memorization assignments, and activities. I understand that the cost for AWANA is a $30 non-refundable fee per school year (to be paid with registration unless other arrangements are made). If my child looses their book or uniform, I will pay for replacement costs. I have read the discipline procedures and will cooperate with AWANA leadership regarding these matters. I have carefully read the parent’s handbook and have had the necessary questions answered.
Parent Signature
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