AWANA REGISTRATION FORM

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Parent/Guardian/Emergency/Other Contact Information:

 
 
 
 
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MEDICAL RELEASE INFORMATION

As a parent / guardian, I do hereby authorize the treatment by a qualified and licensed medical doctor of the above minor in the event of a medical emergency which, in the opinion of the attending physician, may endanger his / her life, cause disfigurement, or undue comfort if delayed.  This authority is granted after all reasonable effort has been made to reach me.  This release form is completed and signed of my own free will with the sole purpose of authorizing medical treatment under emergency circumstances in my absence for the Awana Club year Sept 9, 2022 through May 26, 2023.

 
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PAYMENT INFORMATION

Annual Fee is $35.00.

Please make checks payable to 

Mandarin Baptist Church or MBCSFV

("Awana" in note section)

Cash accepted also

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