. – Heber Springs Baptist Church

Child Name *

First

Last

Age

Selected Value: 3

Date of Birth *

mm-dd-yyyy

Lade Grade Completed. *

Address *

City *

State *

ZIP *

Parent/Guardian *

First

Last

Contact Phone *

Alt Phone

Confirm Email

Do you have a Church home?

Church Name

Emergency Contact *

First

Last

Emergency Contact Number *

Medical Allergies *

Enter N/A if none

I authorize the following people (in additions to the parents listed above) to pick up my child from any AWANA sponsored gatherings.

First

Last

First

Last

First

Last

I give permission for photos or videos of AWANA activities which may contain my child to be used on Heber Springs Baptist Church media platforms. *

This year we are offering AWANA in our traditional Wednesday night club night or an alternative online AWANA program. With the online program the student will have AWANA videos they can watch and then participate in the book time like our traditional program. Please select the button below as to which method is best suited for your child.

Traditional Program
Online Program

Questions? If you have any questions about our AWANA program, please let us know.

Being the legal guardian of the minor named herein, by check box and signature I give Heber Springs Baptist Church and/or its sponsors the authority to secure any medical and/or surgical treatment for the child names above that is determine necessary in the event of an emergency, sickness, or accident. *

I Agree to the statement above

Signature *

First

Last

.

AWANA 2020-21 Registration

AWANA Registration 2020-21

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