Theme image

Participant Registration

Go Back

Registro en Español

Pecan Grove Baptist Chuch

Location

1727 Fm Rd 359

Richmond, TX 77406

Map It

Contact Kaylee Adams:

337-208-5408

kadams@pgbc.org

First, Tell Us About Yourself:

Parent Information

Registration for the 2026-2027 AWANA year at PGBC is for children who will be 3 years old through 5th grade this fall. Registration is $50 per child.

First Name

This field is required.

Last Name

This field is required.

Address 1

This field is required.

City

This field is required.

State/Province

This field is required.

ZIP/Postal Code

This field is required.

Contact Phone 1

This field is required.

Contact Phone 2

This field is required.

Emergency Contact Name

This field is required.

Emergency Contact Phone

This field is required.

Please list any adults, other than the registering parent/guardian, who are authorized to pick up your child/children.

Alternate Pickup Name

This field is required.

Alternate Pickup Phone

This field is required.

Alternate Pickup 2 Name

This field is required.

Alternate Pickup 2 Phone

This field is required.

Home Church Affiliation

This field is required.

Click here for your FREE Notes from Jesus Bundle

By checking the box you will be emailed your Free Notes From Jesus Bundle.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Tell Us About Your Participant

First Name

This field is required.

Last Name

This field is required.

Grade Entering

This field is required.

Gender

This field is required.

Date Of Birth

This field is required.

Medical Concerns

This field is required.

Allergies

This field is required.

RELEASE OF LIABILITY: I understand that Pecan Grove Baptist Church is a nonprofit charitable institution that is voluntarily presenting this program for my child, other participants, and the community. I also understand that the program has activities that can involve physical contact with other participants, the ground, or equipment, and that there is a resulting risk of physical injury to my child. I affirm that my child is in proper physical condition and has no existing injuries or conditions that could jeopardize his/her safety or health, or the safety or health of the other participants. I therefore release and discharge all liability for any harm or injury suffered directly or indirectly as a result of my child's participation in PGBC AWANA Program, whether or not resulting from negligence, and I agree not to sue PGBC, its representatives, staff, or volunteers on any such claim.

I have read and agree to the Release of Liability.

This field is required.

Medical Release:

I give permission for the staff, representatives, or volunteers of Pecan Grove Baptist Church to administer first aid or, in the case of an emergency, to seek medical care for my child during my child's participation in the program, including transportation of my child to a medical facility for additional treatment that appears necessary. I agree to reimburse PGBC for any such costs.

I have read and agree to the Medical Release.

This field is required.

Photo/Video Release: I understand that I and my child may be photographed or filmed during participation in AWANA. I authorize PGBC to use those photos and videos for promotional purposes.

This field is required.

Comments

This field is required.

AWANA Registration Fee: The registration fee for PGBC AWANA is $50 per child. Payment will be collected during check in on AWANA kickoff night, September 9th, 2026.

This field is required.

— or —