new horizons baptist church
AWANA Registration
Your Email:
  *
Last Name:
  *
Child #1:
  *
Date of Birth:
  *
Grade:
  *
Child #2:
  
Date of Birth:
  
Grade:
  
Child #3
  
Date of Birth
  
Grade
  
Parent/Guardian Name(s):
  *
Address:
  *
City, State, Zip:
  *
Home Phone:
  *
Cell Phone:
  
Medications:
  
Allergies:
  
Home Church:
  
Pastor:
  
Primary Emergency Contact - Other than Parent/Guardian ~ Name:
  *
Phone Number:
  *
Secondary Emergency Contact ~ Name
  
Phone:
  
My child has permission to participate in the New Horizons Baptist Church AWANA program. By submitting this form, I will not hold the church, teachers, AWANA organization or other member of NHBC responsible for any accident my child may suffer.*
I authorize the following person/persons to pick my child up in my absence. I understand the AWANA workers have the right to ask for identification from anyone they do not know.
  
This form will be used and in effect for the 2017-2018 AWANA year. Any changes in this information need to be updated and submitted in writing to the AWANA Commander or childs teacher.
Please initial and date:
  *
Verification Code:
Insert above code:
 * Required

NEW HORIZONS BAPTIST CHURCH: 17939 Paver Barnes Road Marysville, OH 43040 937-644-1776