Bible club

Register Your student for Bible club!!

Please fill out one registration form per student!

* Indicates required field

I am signing up my student for: *

PRIMARY School Bible Club INTERMEDIATE School Bible Club MIDDLE School Bible CLub

Student's Name *

First

Last

Student's Age *

Student's Grade *

Birthdate *

Teacher *

Room # *

Allergies / Medical Information *

After Bible Club, my student will be... *

Parent/Guardian Name *

First

Last

Relationship to Student *

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Is there anyone else approved to pick up your student?
Please fill out below:

Name *

First

Last

Relationship to student *

Phone Number *

Submit

 Sunday Service: 10:30am
11269 Broadway St. Alden, NY 14004 • (716) 685-4141