Preston Oaks Baptist Church

AWANA

Awana Page 1 page 1 of 1

First Name Last Name

Select one
Female
Male
Address
Address Line 2
City State Zip Code

First Name Last Name
Phone Number
Phone Number
Email Address

First Name Last Name
Phone Number
I, the undersigned, request that my child (ren) be permitted to participate in the Preston Oaks Baptist Church Awana Ministry. I agree to hold harmless Preston Oaks Baptist Church or any of their agents in the event of accident, illness, injury, or death, which may occur during any and all Awana Sponsored activities. I hereby consent to my child’s participation in interviews, the use of quotes and the taking of photographs, movies or video tapes while participating in a Preston Oaks Baptist Church activity or function. I also grant permission to Preston Oaks Baptist Church to use my child’s name and/or photographs for use in brochures, newsletters, and webpage as well as other forms of media not mentioned. I also hereby release Preston Oaks Baptist Church from all claims, demands, and liabilities whatsoever in connection with the above.
Select all that apply
YES
NO



* required