CLUB YEAR 2018-2019

Preferred Phone:*
Alternate Phone:
Emergency Contact Person:*
Emergency Contact's Phone Number*
Birth Date:*
Medical Information (Allergies or Special Needs)

´╗┐Service Opportunities

What groups of children do you prefer to work with?*
What Leadership Roles are you interested in?
Uniform Size:*

Terms and Conditions Office Use

By Signing Below, I:

1) Commit to serve with integrity and follow club leadership protocol.

2) Commit to set a good example for clubbers by wearing uniform and arriving

on time.

3) Commit to faithfully pray for clubbers assigned to me and the Awana program.

4) Commit to memorize the Gospel Wheel verses.

5) Commit to watch Child Protection training video found at:


6) Grant authorization for the church to run a confidential background check.

I have read and agree to the Terms and Conditions stated above.

Sign & Date*