Bethany United Church of Christ
Featuring the “Bethany Bee”
Thursdays in July (5th, 12th, 19th, 26th)
9:30-11:30 a.m.
For kids who have completed K-5th grade by the end of this school year
Books, Games, Crafts and More with a focus for kids to “Bee” A Good Friend, “Bee” ready to learn, “Bee” helpful, and to “Bee” the best YOU that You can be!”
Please complete and return bottom portion of this form with $5 registration fee per child by June 25th. Pre-registration is required.
Child’s Name: ____________________________________ Date of Birth: _____________
Grade completed at the end of 2017/18 school year: ________
Allergy information: ___________________________________________________
Name of person/s permitted to pick up your child: ______________________________
Parent or Guardian’s Name: ______________________________________________
Emergency Contact: Name: __________________________ phone: _____________________
Address: ______________________________________________________________
Email: _________________________________ Phone number: _____________________________ _
Is there anything you want us to know about your child/children that will help us serve them better during their time with us? __________________________________________________________
I give permission for my child to participate in the Bethany Summer Kids’ Reading Club:
Signature required: _______________________________________
Please mail this form or drop by with $5 per child payment: Bethany U.C.C., 600 West Market Street, Bethlehem PA 18018 (corner of 5th Avenue and Market Street). Office open weekday mornings from 9-1. For more information email [email protected] or call 610-868-4441.
