You may register up to four children with one form. If you also want to purchase the books and uniform shirt/vest your child will need, you may do so on this form. Registration can be paid each month, $5 per child per month, or can be paid in full at a discount when you register.

Cash or checks made out to PCC AWANA would be appreciated to reduce credit card transaction fees.

Please list any health issues that may affect the activities, food consumption, well-being or medical treatment of your child(ren), e.g. conditions like asthma, a physical handicap, allergies, heart condition. Also indicate any medications your child(ren) may be taking. Please include the child's name with information if you are registering multiple children.

Portage Community Chapel and its represerntatives may take and use photos, videos, or other imaging formats of children participating in PCC-affiliated ministries. Participation in these activities constitutes agreement for use of such images for website, facebook, advertising, and other related purposes.

Every activity sponsored by Portage Community Chapel is carefully planned and adequately supervised. However, even with the best of planning and precaution, unforeseen events can occur. By signing this form, I agree to assume and accept all risks and hazards inherent in church-related social activities, both at the church and other locations selected by the church. I also agree not to hold this church or its employees or volunteer assistants liable for damages, losses or injuries to the person or property of the participating clubbers listed above. Every attempt will be made to contact the parent or emergency contact I have listed on this form. However, if I/they cannot be located, I hereby give my permission to the physician or dentist selected by the church leadership to secure proper medical treatment for my child, as deemed necessary. I understand that my electronic signature below is both a medical and liability release.