AWANA Registration 2023-2024
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Child's First Name *
Child's Last Name *
Age *
Grade for the School Year 2023-2024 *
Birth date  *
MM
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DD
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YYYY
Allergies/Medical Concerns *
Legal Guardian's/Mother's Full Name *
Legal Guardian's/Mother's Phone Number *
Legal Guardian's/Father's Full Name *
Legal Guardian's/Father's Phone Number *
Email Address *
Mailing Address *
Emergency Contact Name *
Emergency Contact Phone Number *
The safety of your Child is our primary concern. Precautions will be taken for their well-being and protection. I/we, the parents or guardians named below, authorize Erin Knoppers or one of Paradise Valley Church of God Ministry Personnel to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for your child. I/we, named below, undertake and agree to indemnify and hold harmless Program Personnel, Paradise Valley Church of God, and its leaders from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Paradise Valley Church of God, as well as of any medical treatment authorized by the supervising individuals representing Paradise Valley Church of God. This consent and authorization is effective only when participating in or traveling to events sponsored by Paradise Valley Church of God. By typing your name below and submitting this form, you agree to  the above.
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Purposes and Extent: The Paradise Valley Church of God is collecting and retaining this personal information for the purpose of enrolling your child in our programs, to assign the student to the appropriate classes, to develop and nurture ongoing relationships with you and your child, and to inform you of program updates and upcoming opportunities at our organization. This information will be maintained indefinitely as it is a requirement of our insurance company and legal counsel. If you wish for the Paradise Valley Church of God to limit the information collected, or to view your child’s information, please contact us. By typing your name below and submitting this form, you agree to the above.
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The Paradise Valley Church of God staff has the permission to take my child's photograph. I understand the photos taken may be posted at the church, used for crafts and/or on social media. By typing your name below and submitting this form, you agree to the above. 
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Your typed signature affirms that the information you have given is correct and that you have read and understood the information we have provided on this form.
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