Bethany Good News Bible Club – Registration

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Select number of children attending Bethany Good News Bible Club

Child's Name

Child's Grade

Child # 2 Name

Child # 2 Grade

Child # 3 Name

Child # 3 Grade

Child # 4 Name

Child # 4 Grade

Child # 5 Name

Child # 5 Grade

Child # 6 Name

Child # 6 Grade

Child # 7 Name

Child # 7 Grade

Parent's Name

First

Last

Parent's Email

Parent's Phone Number

(###)-###-####

Address

Street, c/o

Address Line 2

Apartment, Suite, Unit, Building, Floor, etc.

City

State

Country

Zip/Postal Code

Is there anything else we need to know about your child? Notes?

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