AWANA Registration Form (2007-2008)

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.)

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.)

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