Please fill out the registration form as completely as possible. If you have ANY questions, please contact Bethesda Baptist Church at 706-556-6818 (Questions with a red asterisk are required.) Child's Name * Parent/Guardian Name * Address * Home Phone * Work Phone Cell Phone Email Birth Date * Last Grade Completed * Medical Info (include food allergies) Emergency contact name: * Emergency Phone * Second Emergency Contact Second Emergency Phone Who may pick up your child each day? * Do you attend Sunday School? * Yes No If so, Where? If you are a visitor, who are you a guest of? Do we have permission to photograph your child? * Yes No May we have permission to use your child's picture in church publications? * Yes No Please type the letters and numbers shown in the image. Click the image to see another captcha.