LIFE Ministry Registration
We are so excited for another year of LIFE Ministry at Bethany Alliance Church on Wednesday evenings from 6:30 pm-7:30 pm!!

Please complete this form to register your family for the upcoming school year. LIFE is for children in K-4th Grade, and Bullfrogs & Butterflies is for preschool age children.

Family Information
Parent(s) Name
Your answer
Address
Your answer
City, State, Zip Code
Your answer
Email
Your answer
Phone Number
Your answer
Do you receive text messages?
Emergency Contact
Your answer
Emergency Contact Phone Number
Your answer
Family Doctor
Your answer
Insurance Company
Your answer
Home Church
Your answer
Are you registering a child who is in Preschool?
(Bullfrogs & Butterflies is for children in preschool. LIFE is for children in K-4th Grade.)
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