Awana Leader Registration

Awana Begins Wed. Sept 5, 2018 | Please fill out this registration form and click submit.

Please Complete Information

Name

Cell Phone Number

This address will receive a confirmation email

Address

Emergency Contact

Name

Mobile Phone

Please read the following Waiver of Liability Photo/Video Release.

PHOTO/VIDEO RELEASE - I understand that photos and videos of me may be taken at these activities for publication. I waive any claim for damages against Amity Bible Church or its representatives from unconsented use, altering or republication of my image by third parties accessing the Internet/WorldWideWeb. If my desires change or any changes to this form need to be made, it is my responsibility to notify Amity Bible Church in writing of these changes.

Do you consent to the Photo/Video Release?

Please select one option.

No Yes

I wish to donate to AWANA 2018/2019

Registration fee due by August 12, 2018

Area of Service

Please select all that apply.

Club Director Club Leader Floater/Listener Games Registration Security Snacks

Preferred Club

Please select all that apply.

Cubbies Sparks T&T Girls T&T Boys Trek Journey N/A

Uniform Needed

Please select one option.

Yes No

Uniform Size

Please select one option.

N/A Small Medium Large X Large 2X-Large 3X-Large

Select Uniform/Price

No Thanks ($0) Cubbies Ladies ($21.99) Sparks Ladies S-XL ($21.99) Sparks Ladies 2XL ($26.99) Sparks Mens S-XL ($21.99) Sparks Mens 2XL ($26.99) T&T Ladies S-XL ($21.99) T&T Mens S-XL ($21.99) T&T Mens 2XL ($26.99) Trek/Journey Ladies S-L ($21.99) Trek/Journey Ladies XL-2XL ($26.99) Trek/Journey Mens S-XL ($21.99) Trek/Journey Mens 2XL-3XL ($26.99) Support Leader Ladies S-XL ($21.99) Support Leader Ladies 2XL-3XL ($26.99) Support Leader Mens S-XL ($21.99) Support Leader Mens 2XL-3XL ($26.99)

Amount

Please use this space for additional information or questions.

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Awana Begins Wed. Sept 5, 2018

Please fill out this registration form and click submit.

Awana Leader Registration

Description

Please Fix the Following