AWANA Registration

Welcome Vista Grande Community Church is excited for another year of AWANA. This year's program begins on Sunday, September 18th and will meet at our new time of 4pm to 6pm. You can register you child now and let us know if you want to volunteer, by filling out this online form. For more information, contact Kristen Nahrstedt at Kristen@vgc.org or by calling the church office at (858) 560-9350.

Child's Name
First and Last

Birth Date
Month/Date/Year

Parent(s)/Legal Guardian
Please give first and last name and relationship to child

Street Address

City, ZIP

Email Address
Please use only if email is an effective way to communicate with you

Best Contact Phone Number
Please include area code

Altnerate Contact #1
Name and number with area code

Alternate Contact #2
Name and number with area code

Select Correct Age Group

Grade in fall of 2011

Need a Vest?

YES No

Name of church you regularly attend

I am interested in volunteering

YES No

Health Insurance Company

Policy or Group Number

Medical Release Medical Release: I (We), the undersigned parent(s) or guardian(s) of _____________________________ A minor, do hereby authorize adult volunteers of VGCC as agent(s) for the undersigned, to consent to any medical or surgical care deemed advisable by any accredited physician or surgeon in an approved emergency clinic or hospital. I further release from any liability VGCC or Awana International, or any of its ministries or leaders in the event of an accident en route, during and returning from the above mentioned event. This agreement does not apply to claims for intentional misconduct or gross negligence.

Primary Doctor
Name and phone number with area code

Special Health Needs
Asthma, food allergies, physical limitations, allergic to bee stings etc.

Other Concerns/Needs

Internal Use Only The following area is for internal use only. Please hit the submit button as soon as all information above has been entered. Thank you!

Registration Amount: $_____________ Registration Date: ________________

Uniform Amount: $ ____________ Cash _________ Check# ______________

Book Amount: $ ___________

Total Paid: $ ___________

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