AWANA at Crossroads Bible Church
Please submit a separate form for each child.
Puggles (2 & 3 years)
Sparks (K 1st 2nd)
T & T (3rd 4th 5th 6th)
Which club will your child belong to?
Allergies and Medications
Anything else you want to tell us
Please read the medical release below
I authorize Crossroads Bible Church to administer first aid and to obtain and consent to on my behalf for any emergency first aid or medical care by any physician or hospital for my child. I agree to abide and be bound by such decisions and consents as if made by me. I further authorize any physician, hospital or medical attendant to receive full and complete medical records or information deemed necessary with respect to the treatment of my child. Execution of this document shall operate as an authorization for such person(s) to receive any medical information which they require.