Parent/Guardian Name *

First Name

Last Name

Phone *

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Child's Name *

First Name

Last Name

Birthdate *

MM

DD

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Gender

Male

Female

Name

First Name

Last Name

Birthdate

MM

DD

YYYY

Gender

Male

Female

Name

First Name

Last Name

Birthdate

MM

DD

YYYY

Gender

Male

Female

Terms & Conditions - By Clicking "I Agree" you have read and agree to the terms above. *

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 a risk of injury. I fully accept this risk and hold harmless from any legal liability, Westport Baptist Church and any persons involved in the Awana Club ministry.

I Agree

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2) In the event of an emergency that requires medical treatment for the above named child/children, I understand that every effort will be made to contact me. However, if we cannot be reached, I give my permission to the AWANA volunteers to secure the services of a licensed physician to provide the care necessary for my child's well being. I assume responsibility for all costs connected to an accident or treatment of my child/children.

I Agree

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I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing. I further acknowledge that Westport Baptist Church has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.I further acknowledge that Westport Baptist Church and its leaders can not guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Awana staff, and other Awana children and their families.I acknowledge that I must comply with all set procedures to reduce the spread while attending Awana.I hereby release and agree to hold Westport Baptist Church, their staff, and their leaders harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the church, or that may otherwise arise in any way in connection with any service from Westport Baptist Church. I understand that this release discharges Westport Baptist Church from any liability or claim that I, my heirs, or any personal representatives may have against the church with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to Westport Baptist Church.

I agree