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Grace Chapel Awana Registration 2024-2025
ONLY 1 CLUBBER PER FORM
Name of Clubber
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First
Last
Date of Clubber's Birth
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MM
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DD
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YYYY
Gender
Male
Female
Allergies
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Please select
Yes
No
If Yes on Allergies, Please List:
School Grade Clubber will be in 2023/2024
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Awana Club
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Please select
Cubbies - Preschool
Sparks - Kinder thru 2nd
T&T - 3rd - 6th
Trek - Middle school
Journey - 9th - 12th
***Cubbies MUST be potty trained***
Parent/Guardian Name
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First
Last
Cell#
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Confirm Cell #
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Email
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Confirm email
Clubber's Address
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Street Address
City
State / Province / Region
Postal / Zip Code
Alternate Emergency Contact Name:
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Alternate Emergency Contact Cell#
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Confirm Emergency Contact Cell #
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Phone
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Family Church
Club Dues (mandatory) 1st child in family $55.00
Club Dues (mandatory) for Add'l Child in Family $40
Please send information on Volunteering
Please send me information on Scholarships
Registration Fee [NOTE: Scholarships available as needed.]
Book, Uniform, and Bag.
Book - No Cost
Uniform Vest $14.20
Optional book bag $7.00
Cubbies (Ages 3-4) and Sparks (Grades K-2)
Book - No Cost
Uniform Shirt $19.20
Optional book bag $15.60
T&T (Grades 3-6)
Book - No Cost
Uniform Shirt - 19.00
Optional book bag $15.60
Trek and Journey (grades 7-12)
Discounts cannot be recorded on this form. If you do wish to volunteer the discounts are as follows:
1 parent - two nights a month 25%
2 parents - two nights a month 35%
1 parent - full time 50%
2 parents - fulling 60%
1 or 2 parents in a director position 75%
Parents who are volunteering can complete this form, but not pay until the first night we meet.
or
Complete the form including payment and request a refund.
Discounts may be taken off the registration fee only. All other items are sold at cost.
If you have a question contact Chris Richards - 720-530-7997
TERMS and CONDITIONS
1) I understand that my child/children may participate in physical activities such as those held during game time. As with any physical activity, there is risk of injury. I fully accept this risk, and hold harmless from any legal liability, Grace Chapel Castle Rock and any persons involved in the Awana Club ministry.
2) In the event of an emergency that requires medical treatment for the above named child/children, I understand every effort will be made to contact me or emergency contact. If I/we cannot be reached, I permission to Awana volunteers to secure services of a licensed medical professional to provide the care necessary for my child's well being. I assume resoponsibility for all costs connected to any accident or treatment of my child.
3) I grant permission for photos of my child to be taken for promotional and slideshow for special occasions.
4) I grant permission for my child's club leader or program director to periodically contact me by mail, email or phone.
I have read and agree to the terms stated above.
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I agree to the terms stated above
I do not agree. AWANA Ministry Director will contact you to discuss Terms and Conditions
Signature
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