AWANA – Pre Registration Parent and/or Guardian InformationName* First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Email Child InformationHow many children will attend?*1234Name*NicknameAgeAllergiesName*NicknameAgeAllergiesName*NicknameAgeAllergiesName*NicknameAgeAllergies* I have read and agree to the Terms and Conditions stated below.Terms & Conditions 1. I understand that my child(ren) may participate in physical activities such as those held during Game Time. As with any physical activity, there is a risk of injury. I fully accept this risk and hold harmless from any liability, Pleasant Grove Bible Church 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(ren), I understand every effort will be made to contact me or my emergency contact. However, if I/we cannot be reached, I give permission to the AWANA volunteers to secure the services of licensed emergency personnel to provide the care necessary for my child's well-being. I assume responsibility for all costs connected to any accident or treatment of my child. 3. I grant permission for a photo of my child to appear in an unpublished club directory to be used by AWANA Leaders only. I also give permission for photo(s) of my child to appear among other general club photos as long as there is no identifying information shown. 4. I grant permission for my child to travel to/from AWANA Club events with an adult leader. Any such event will be clearly communicated to me beforehand. This iframe contains the logic required to handle Ajax powered Gravity Forms.