Living Hope Church 2017-18 AWANA Registration

Living Hope Church is a recent merger between Christ the King Church (Batavia) and Union Congregational Church (North Aurora). The two churches began worshipping together in April at Union's building - 405 W State St, North Aurora.

For the last 10 years, Christ the King Church hosted an AWANA program at the Eastside Community Center in Batavia. This year, that program will be run at Living Hope Church in North Aurora. The same leadership team and the same core group of volunteers will continue to teach children about the love of God in Christ!

WHEN: Sunday Nights - 6:00-7:30PM (Starting Sept. 17 - April)

WHERE: Living Hope Church - 405 W State St, North Aurora

COST: $40 ($5 discount for each additional child) + cost of supplies

PAYMENT - Details are below. We can accept payment via cash, check or online via Dwolla (no credit cards, ACH transfer from checking accounts).

[This form gets a little goofy if you are using a mobile device...you might need to toggle portrait/landscape mode in order to view it correctly, sorry!]

If you would prefer to use a paper form for registration, you can find them here:
Cubbies
Sparks
T&T

If you have any questions, please contact Pastor Jeff Holwerda (jeff.holwerda@livinghope.ch).

How many children are you registering? *

Child's name *

First Name Last Name

Child's birth date *

Month Day Year

Child's grade in school *

Child's school

My child's friends at this AWANA Club

Medical or other information we may need to know about the child (including food allergies).

Child's name *

First Name Last Name

Child's birth date *

Month Day Year

Child's grade in school *

Child's school

My child's friends at this AWANA Club

Medical or other information we may need to know about the child (including food allergies).

Child's name *

First Name Last Name

Child's birth date *

Month Day Year

Child's grade in school *

Child's school

My child's friends at this AWANA Club

Medical or other information we may need to know about the child (including food allergies).

Child's name *

First Name Last Name

Child's birth date *

Month Day Year

Child's grade in school *

Child's school

My child's friends at this AWANA Club

Medical or other information we may need to know about the child (including food allergies).

Child's name *

First Name Last Name

Child's birth date *

Month Day Year

Child's grade in school *

Child's school

My child's friends at this AWANA Club

Medical or other information we may need to know about the child (including food allergies).

Child's name *

First Name Last Name

Child's birth date *

Month Day Year

Child's grade in school *

Child's school

My child's friends at this AWANA Club

Medical or other information we may need to know about the child (including food allergies).

Parent/Legal Guardian Names *

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Home Phone Number

- Area Code Phone Number

Parent/Legal Guardian Mobile Numbers *

Parent/Legal Guardian Email Addresses *

Names of persons who are authorized to pick up your child (MUST LIST AT LEAST TWO) *

Emergency Contact 1 (other than parent/guardian listed above) *

First Name Last Name

Emergency Contact 1 Phone Number *

- Area Code Phone Number

Emergency Contact 2 (other than parent/guardian listed above)

First Name Last Name

Emergency Contact 2 Phone Number

- Area Code Phone Number

Do you regularly attend a church in the area?

Yes No

If yes, which church do you attend?

Family Doctor Name & Preferred Hospital *

Family Doctor Phone Number *

- Area Code Phone Number

Medical/Liability/Photo Release:
We realize that no activity is without the possibility of unforeseen hazards which could result in injury to an individual. As a parent or guardian, you are to be aware of your responsibility to instruct your child(ren) of the importance of conduct which will insure safety and an enjoyable time while participating in this activity. By checking 'I Agree', you, as a parent/guardian, agree to assume the risks and hazards which are inherent in this kind of activity. You also agree to absolve and hold harmless the sponsoring organizations and their representatives for damage, loss or injuries to the child(ren) for whom you sign. You further give permission for photographs and/or video in which your child appears in to be used by the sponsoring organizations in printed and/or electronic media. You give your child(ren) permission to participate in this activity, and give your permission to the leaders of this function to authorize any treatment deemed necessary by a licensed physician due to accident or illness during this activity.

*

I Agree to the Medical & Liability Release above I Don't Agree to the Medial & Liability Release above

Each child needs two required items for AWANA each week.
1. AWANA Handbook
2. AWANA Uniform
These items need to be ordered and purchased. Details are below. Please read this information carefully and completely.

Your child also needs to bring two other items.
1. A Bible (Living Hope church can supply one for you)
2. A bag with their name on it for their supplies (official AWANA bags can be ordered below, or you can use your own bag from home)

NEW CLUBBERS - If you are brand new to AWANA, you will need to make sure that you order BOTH items for each of the children you are registering.

CUBBIES (3-5 yrs old) - All Cubbies need a NEW handbook each year. So, if you are a returning Cubbie, you can reuse your vest, but must get a new book.

SPARKS (K-2nd) - If you are new to Sparks, you need to order both a handbook and vest. If you are a returning Sparkie, reuse your vest if it still fits. If you finished your handbook last year, order the next one. If you did not finish your handbook last year, keep working on that book this year.

T&T (3rd-6th) - Things are a bit more complicated for T&T! :-) There are different books and shirts for 3-4th grades and 5-6th grades. If you are new to T&T, choose the 1st book and shirt for your age bracket. If you are returning to T&T, you might need a new shirt, or you can keep your old one. If you finished your handbook last year, order the next one. If you are in the middle of a handbook, keep working on that one.

SUPPLIES ORDER FORM
Please use the form below to order the supplies that you will need for the coming year.

Please order what you will need for ALL of the children you are registering using this single form.

Please include the club dues for each child. Your completed order form will tell you the total amount of your payment at the bottom. Payment options (in-person or online) are explained below.

[This form gets a little goofy if you are using a mobile device...you might need to toggle portrait/landscape mode in order to view it correctly!]

If you have any questions, please contact Pastor Jeff Holwerda - jeff.holwerda@livinghope.ch.

Annual Club Dues - REQUIRED for ALL Clubbers ($40/child, $5 discount for each additional) $ 40.00

Quantity

Cubbies (3-5 yrs) - Handbook (REQUIRED for all Cubbies) $ 10.00

Quantity

Cubbies (3-5 yrs) - Vest (REQUIRED for all Cubbies) - Check the Box for SIZING Options $ 10.00

Cubbies Vest Size	Quantity
Large (6)
X-Large (8)

Item subtotal: $ 0.00

Cubbies (3-5 yrs) - Book Bag (OPTIONAL) - Blowout Sale Price! :-) $ 2.00

Quantity

Sparks (K-2nd) - Handbook (REQUIRED for all Sparkies) - Check the Box to Choose Your Book [NOTE - if your child is in the middle of a book from last year, they need to finish that book before moving on to the next book.] $ 10.00

Sparks Books	Quantity
HangGlider (Book 1)
WingRunner (Book 2)
SkyStormer (Book 3)

Item subtotal: $ 0.00

Sparks (K-2nd) - Vest (REQUIRED for all Sparkies) - Check the Box For SIZING Options $ 10.00

Sparks Vest Sizes	Quantity
Large (10)
X-Large (14)

Item subtotal: $ 0.00

Sparks (K-2nd) - Book Bag (OPTIONAL) - Blowout Sale Price! :-) $ 2.00

Quantity

T&T (3rd-6th) - Handbook (REQUIRED for all T&Ters) - Check the Box to Choose Your Book [NOTE - if your child is in the middle of a book from last year, they need to finish that book before moving on to the next book.] $ 10.00

T&T Handbooks	Quantity
Ultimate Adventure (3rd-4th Grade) Book 1
Ultimate Adventure (3rd-4th Grade) Book 2
Ultimate Challenge (5th-6th Grade) Book 1
Ultimate Challenge (5th-6th Grade) Book 2

Item subtotal: $ 0.00

T&T (3rd-6th) - Uniform (REQUIRED for all T&Ters) - Check the Box For SIZING Options $ 12.00

T&T Jersey Sizes	Quantity
Ultimate Adventure (3rd-4th) Jersey - Youth Small
Ultimate Adventure (3rd-4th) Jersey - Youth Medium
Ultimate Adventure (3rd-4th) Jersey - Youth Large
Ultimate Adventure (3rd-4th) Jersey - Adult Small
Ultimate Challenge (5th-6th) Jersey - Youth Medium
Ultimate Challenge (5th-6th) Jersey - Youth Large
Ultimate Challenge (5th-6th) Jersey - Adult Small
Ultimate Challenge (5th-6th) Jersey - Adult Medium

Item subtotal: $ 0.00

T&T (3rd-6th) - Drawstring Bag (OPTIONAL) - Blowout Sale Price! :-) $ 2.00

Quantity

Total $ 0.00

PAYMENT OPTIONS

You may choose one of two options (pick below) to pay for your registration.

1. Cash or Check - You can simply bring cash or a check (made payable to Living Hope Church) on the first night of AWANA. You can also mail your payment or drop it off in person at the church office - 405 W State St, North Aurora, 60542.

2. Online Payment via Dwolla - If you would like to pay online (no credit card payments, only ACH transfers from a checking/savings account) we use a safe and secure online payment service called Dwolla. You will need to create an account in order to use that service. NOTE - the amount of your registration (Total: listed above) will not transfer to the Dwolla payment page, so please note that amount so you can make your payment.

How would you like to pay? *

Cash or check (payable to Living Hope Church) Dwolla Online Payment (free to use, requires simple account set-up)

DON'T FORGET TO CLICK "SUBMIT" BELOW!!

Thank you for your registration.

Please bring your payment in the form of cash or a check (made payable to Living Hope Church) on the first night of AWANA. You may also mail your payment or drop it off in-person at the church office - 405 W State St, North Aurora, 60542.

In order to complete your registration, you MUST CLICK "Submit Your Registration" below!

Thank you for your registration. You are almost done! :)

To complete your online payment via Dwolla, please complete these three steps. (Please don't forget Step 3!!)

1. Note the total amount due for your registration (listed above).

2. Click this link which will open a payment page in another window - Dwolla Online Payment. Enter the amount due and complete your payment.

3. IMPORTANT - Return to this page and click the "Submit Your Registration" button below. We will not receive your registration if you do not complete this step!

Paid?

Cash Check

Living Hope Church 2017-18 AWANA Registration

Child Information

Child #1

Child #2

Child #3

Child #4

Child #5

Child #6

Child Release Information

Medical and Media Release

Supplies Order Form

For Office Use Only: