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Bethany Student Ministry
Fill out form for each Youth 6th grade and up. Meets Wednesdays 6:00 - 7:30 pm
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* Indicates required question
Youth's name
*
Your answer
Age or school grade
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Your answer
Birthdate
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Your answer
Allergies and Medical conditions leaders need to know
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Your answer
Name of parent(s)
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Your answer
Address
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Your answer
Phone number
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Your answer
Email (If no email, write "none")
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Your answer
For updates or reminders related to Bethany Student Ministry, which do you prefer?
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Text
Email
Phone call
In case of emergency, if unable to reach parent at above phone number, who should we contact? Give name, relation to youth, phone number
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Your answer
PHOTOS taken during Youth activities may be used to promote future Youth activities at Bethany Baptist Church. NO NAMES WILL BE USED WITH THE PHOTOS. Do you give us permission to use your youth's photos for that purpose?
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YES, you may use my youth's photos for the above purpose
NO, DO NOT use photos of my youth for the above purpose.
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