Lightbearers 23-24

Wednesdays 6:30-8:00pm | Thank you so much for registering your family for Lightbearers at Gashland Baptist Church! We are so excited to have you and your family join us this year.

If you have any questions on Lightbearers contact Pastor Ryan at pastornix@gashlandbc.org.

Lightbearers runs September-May every Wednesday from 6:30-8:00pm

Participant Name

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Preferred Name for Name Tag

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T-Shirt Size (Specify Youth or Adult)

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Gender

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Please select one option.

Male Female

Birthday (MM/DD/YYYY)

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Current Grade

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Please select one option.

Preschool Kindergarten 1st 2nd 3rd 4th 5th 6th

Allergies, Medical, & Special Needs: (Type N/A if None)

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Parent/Guardian Name:

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Address

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Phone

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Email

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This address will receive a confirmation email

Emergency Contact Name (1)

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Emergency Contact Phone (1)

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Emergency Contact Name (2):

Emergency Contact Phone (2)

Authorized Pickup #1

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Authorized Pickup #2

Authorized Pickup #3

Authorized Pickup #4

May we have permission to photograph your child for use in church publications?

*

Please select all that apply.

Yes No

Is your family currently attending church on Sundays?

*

Please select all that apply.

Yes No

If so, where?

Comments?

Description

Wednesdays 6:30-8:00pm

Thank you so much for registering your family for Lightbearers at Gashland Baptist Church! We are so excited to have you and your family join us this year.

If you have any questions on Lightbearers contact Pastor Ryan at pastornix@gashlandbc.org.

Lightbearers runs September-May every Wednesday from 6:30-8:00pm

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