Allergies and Medical conditions leaders need to know *
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Name of parent(s) *
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Address *
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Phone number *
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Email (If no email, write "none") *
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For updates or reminders related to Bethany Student Ministry, which do you prefer? *
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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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? *