Bethel Presbyterian Church

Please copy the form below or click on the PDF below and send to Bethel Presbyterian Church to register for Vacation Bible School.
https://odcsuffolk.com/wp-content/uploads/2012/06/dinner-is-served.jpg 

Bethel Presbyterian Church

300 Knox Rd.

McLeansville, NC 27301

bethelpresby1812@gmail.com

STUDENT REGISTRATION FORM

 

July 12 – July 15, 2021

5:30 pm – 8:00 pm

  


Child’s Name ___________________________________________________________________________

Child’s Age ________         Child’s Birth Date ________________           Child’s Grade ________

Parent/Guardian Name(s) _______________________________________________________________

Home Phone _______________         Work Phone _______________         Mobile _______________

Email ________________________________________ Preferred Contact Method _______________

EMERGENCY INFORMATION

Emergency Contact 1 _________________________________________ Phone _________________

Emergency Contact 2 _________________________________________ Phone _________________

Allergies or Special Needs _______________________________________________________________



 


Parent/Guardian Signature _________________________________________   Date ______________

Document