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