Please complete a separate registration form for each child attending Awana.

Cubbies:  3-5 yrs old
Sparks:  K-2nd grade
T&T:  3rd-6th grade

AWANA activities may include, but are not limited to, running, throwing, and jumping.
Dates of Activity:  Sept 2021-April 2022
Time of Activity:  Wednesdays, 6:15-8:00pm

Medical Release and Hold Harmless Agreement:
I hereby authorize the emergency medical treatment while under the care and custody of Lake Hills Baptist church and hold harmless the church and its agents or assigns and representatives, including volunteer workers for any harm arising from the said treatment or the lack of said treatment.
I understand that Lake Hills Baptist nor its workers are responsible for administering any medications and I acknowledge that Lake Hills Baptist Church nor any of its workers are authorized to make any medical diagnosis nor administer any medical procedures, expecting those actions deemed proper and necessary in an emergency where they may act as a "Good Samaritan" and render aid and assistance as allowed under the laws of Indiana, whose jurisdiction is agreed to by myself as applicable.
By checking the box below, the parent/guardian gives consent to the said child to participate in a church sponsored activity.  The undersigned agrees to hold harmless (which means to not assign blame or legal responsibility) the Lake Hills Baptist Church, its officials and those workers assisting in the activity from any and all harm that may be sustained as a result of or during the activity, including transportation to and from the activity.  Parent further agrees to resolve any dispute arising from any harm where the matteris, by mutual consent, deemed not covered by this consent or over the consent itself, by submission to binding arbitration.