Bethlehem Kids' 2018
Child's First Name *
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Nickname
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Child's Last Name *
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Grade (fall of 2018) *
Date of Birth *
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DD
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YYYY
Parent Name(s) *
Your answer
Mailing Address *
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E-mail Address *
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Best Phone Number *
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Special Information (allergies, special needs, changes at home, etc)
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Contact me about volunteering! *
Required
Does Bethlehem Covenant Church have permission to use your child's photo on Bethlehem's Facebook page, Bethlehem's Instagram, and on informational material? *
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