Christian Education Registration

24-25 Christian Education Registration

Parent Contact Information

Parent's Names(Required)

Parent Cell Phone Number(Required)

Please list the number of the parent we should first contact in case of an emergency.

Other Parent's Cell Phone Number

Parent Email(Required)

Home Address

Street Address Address Line 2 City State ZIP Code

Are you a member of Bethel?(Required)

Yes

No- I would like information about membership

No- I am not interested in membership at this time

Emergency Contact's Name(Required)

First Last

Emergency Contact Cell Phone Number(Required)

Relationship to Child(ren)(Required)

Information for Child(ren)

Child's Name	Actions

There are no Children.

Are there any special circumstances that we need to be aware of to best serve your family?

Examples include custody arrangements, people not allowed to pick up your child(ren), unique circumstances at home, etc.

Photo Relase(Required)

Pictures may be taken of your child(ren) while at Bethel Lutheran Church events. These pictures may be posted at the church or at www.bethelwahpeton.com, www.facebook.com/bethewahpeton, or Instagram @bethelwahpeton

I give Bethel permission to take and use my child(ren)'s picture

I DO NOT give Bethel permission to take and use my child(ren)'s picture

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