KidsZone Registration 2023-2024

Please fill out this form and click submit.

KidsZone will take place on Sunday evenings, beginning September 10, 2023

Child's Name

*

Date of Birth

*

Grade

*

Please select one option.

Kindergarten 1st 2nd 3rd 4th 5th

Parent Email

*

This address will receive a confirmation email

Parent Phone

*

School Attending

Emergency Contact Name

*

Emergency Contact Phone

*

Address

*

Allergy/Medical Information

*

Would you like to receive communication from Bethany?

*

Please select all that apply.

Texts Emails Both No, Thank You

Photo Release: Photos will be taken throughout the program activities. I give my permission for my child to be in these photos that may be used in promotional materials and on Bethany Baptist Church's social media accounts. Please sign here by entering your first and last name as a signature.

*

Description

Please fill out this form and click submit.

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