2026-27 AWANA Registration & Medical Release • Maranatha Baptist Church

This form is used to gather family information so we can best care for your children.

A separate link is provided for payment. The cost per child is $25–$60, which covers uniforms, books, and club dues (which help pay for teaching materials, game equipment, awards, prizes, and more). We want every child to be able to participate in Awana, and scholarships are available for families in need.

For information about financial assistance, please email office@mbccolumbus.org before completing the payment.

Parent(s) Contact Info

Parent #1 First Name *

Parent #1 Last Name *

Parent #1 Mobile Number *

Parent Email Address *

Parent #2 Full Name

Parent #2 Mobile Number

Home Address *

Home City *

Home Zip Code *

Home Address Line 2

Home State *

How did you hear about AWANA? *

Name of friend who invited you *

If other, please explain. *

Do you have a regular Church Home? *

Name of your Church Home *

Emergency Contact Info

Emergency Contact #1 Full Name *

Emergency Contact #2 Full Name *

Emergency Contact #1 Mobile Phone *

Emergency Contact #2 Mobile Number *

4-Digit Pickup PIN Number *

Tip: We will use the same PIN# for kids from the same family, regardless of whether they are in Sparks or T&T

Please list the people that are allowed to pick up your children. *

Child #1 Info

First Name *

Last Name *

Date of Birth *

Name of School *

Grade entering fall of 2026 *

Allergies (foods, drugs, other) (if none, type N/A) *

Please list any additional info that is helpful for us to know so that we can serve your child effectively and make sure their needs are met.

Do you have another child to add to this medical release? *

Child #2 Info

Child #2 First Name *

Child #2 Last Name *

Child #2 Date of Birth *

Name of School *

Grade entering fall of 2026 *

Allergies (foods, drugs, other) (if none, type N/A) *

Please list any additional info that is helpful for us to know so that we can serve your child effectively and make sure their needs are met.

Do you have another child to add to this medical release? *

Child #3 Info

Child #3 First Name *

Child #3 Last Name *

Child #3 Date of Birth *

Name of School *

Grade entering in fall 2026 *

Allergies (foods, drugs, other) (if none, type N/A) *

Please list any additional info that is helpful for us to know so that we can serve your child effectively and make sure their needs are met.

Do you have another child to add to this medical release? *

Child #4 Info

Child #4 First Name *

Child #4 Last Name *

Child #4 Date of Birth *

Name of School *

Grade entering in fall 2026 *

Allergies (foods, drugs, other) (if none, type N/A) *

Please list any additional info that is helpful for us to know so that we can serve your child effectively and make sure their needs are met.

Do you have another child to add to this medical release? *

Child #5 Info

Child #5 First Name *

Child #5 Last Name *

Child #5 Date of Birth *

Name of School *

Grade entering in fall 2026 *

Allergies (foods, drugs, other) (if none, type N/A) *

Please list any additional info that is helpful for us to know so that we can serve your child effectively and make sure their needs are met.

Awana Kick-off Sept 2nd @ 6:00 p.m.

How many hot dogs should we cook for your family? *

Consents

I hereby give my consent to Maranatha Baptist Church and its leaders to obtain medical or surgical care for my (our) dependent(s) should an emergency arise in which such service is indicated. *

Release of Liability & Assumption of the Risk

In consideration of being allowed to participate in Maranatha Baptist Church programs, events and activities, the undersigned acknowledges, understands, and agrees that:

There is the possibility and risk of injury, even serious injury, associated with my child(ren)’s participation; and,
There is the possibility and risk of exposure to and illness from infectious diseases associated with my child(ren)’s participation, including but not limited to MRSA, influenza, and COVID-19. While particular protocols and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,
I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my child(ren)’s participation; and,
I agree to carry insurance, or have the financial resources, to cover the expenses related to personal illness, personal injury, injury caused to others, and/or damage to property.
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Maranatha Baptist Church, its officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, volunteers, host families, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Enter the name of each participating child.

Parent/Gardian Digital Signature *

Tip: Please Type Your Full Name

Date