RM_Stats 2020-2021 Mt. Zion Baptist Church AWANA Cubbies, Sparks, T&T, and Trek/JourneyAWANA has moved to Sunday Nights at 6:30pm for the 2020-2021 year starting October 11th. NameSchool GradeBirth DateBus Rider To And From AWANA Yes No Home Address Address Line 1 * Address Line 2 City * State or Region Alabama Alaska Arizona Arkansas Armed Forces America Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State or Region * Country Zip * Parent(s) NameParent(s) NameEmail Address *Home PhoneCell PhoneReceive Text Updates/Announcements Yes No Emergency Information(Person to be contacted if parents cannot be reached) Format: Name, Relationship, Phone NumberEmergency Contact #1:Emergency Contact #2Physician's NamePhysician's Number:Medical Conditions: Medical & Liability Release - Valid September 2020 - May 2021Medical ReleaseI agreeIn the event of sickness or medical emergency, I request that my child receive any medical attention or treatment deemed necessary. Therefore, I give permission to any hospital, doctor and/or health care provider to transport, treat, and/or admit for care my child. In the event that I am not present at the time of the emergency or cannot be contacted, care for my child has been entrusted to the staff and designated ministry leadership of Mt. Zion Baptist Church.Your NameDate of Signature Photo Publishing ReleasePhoto releaseI agreeI give permission for Mt. Zion Baptist Church to use the photo or video of my child on the Mt. Zion Baptist Church and AWANA Facebook pages and the church website.Your NameDate of Signature AWANA ExpensesDUES: $1 per week or $27.00 for the 2020-2021 AWANA yearCheck all items that you would like to purchase.Items For Purchase (Cubbies) Book ($10) Vest ($11) Bag ($7) Please make check payable to Mt. Zion Baptist Church. Financial assistance is available upon request.Items For Purchase (Sparks) Book ($10) Vest ($11) Bag ($7) Please make check payable to Mt. Zion Baptist Church. Financial assistance is available upon request.Items For Purchase (T&T) Book ($10) T-Shirt ($8) Uniform Shirt ($16) Bag ($7) Please make check payable to Mt. Zion Baptist Church. Financial assistance is available upon request.Items For Purchase (Trek/Journey) Book ($19) T-Shirt ($15) Bag ($12) Please make check payable to Mt. Zion Baptist Church. Financial assistance is available upon request.Please make check payable to Mt. Zion Baptist Church. Financial assistance is available upon request. Thank you for signing your child up for AWANA at Mt. Zion! Here are some important dates to know:October 4th - Parents' NightOctober 11th - AWANA startsAdditional Notes: Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
AWANA has moved to Sunday Nights at 6:30pm for the 2020-2021 year starting October 11th.
(Person to be contacted if parents cannot be reached) Format: Name, Relationship, Phone Number
DUES: $1 per week or $27.00 for the 2020-2021 AWANA year
Check all items that you would like to purchase.
Please make check payable to Mt. Zion Baptist Church. Financial assistance is available upon request.
Thank you for signing your child up for AWANA at Mt. Zion! Here are some important dates to know:
October 4th - Parents' Night
October 11th - AWANA starts
