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Pathfinders 2019/2020 Registration
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Last name
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Your answer
First name
*
Your answer
Birthdate
*
Your answer
Grade/Class
*
Preschool (4s and 5s)
Kindergarten
1st
2nd
3rd
4th
5th
6th
Required
Street address
*
Your answer
City
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Your answer
State
*
Your answer
Zip code
*
Your answer
Phone #
*
Your answer
Parents Name
*
Your answer
Emergency Contact Name
*
Your answer
Emergency Phone #
*
Your answer
Email
*
Your answer
Medical/Allergy Information
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Your answer
My child may be picked up by
*
Your answer
Photos may be taken of my child by Bethesda Baptist for local church use only
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No
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