Calendar | Bethlehem Missionary Baptist Church

Summer Day Camp Signup Form

The month of February is recognized as Black History Month.

Feb 15 – Mar 15 all-day

The month of February is recognized as Black History Month.

Feb 16 – Mar 16 all-day

The month of February is recognized as Black History Month.

Feb 17 – Mar 17 all-day

The month of February is recognized as Black History Month.

Feb 18 – Mar 18 all-day

The month of February is recognized as Black History Month.

Feb 19 – Mar 19 all-day

The month of February is recognized as Black History Month.

Feb 20 – Mar 20 all-day

The month of February is recognized as Black History Month.

Feb 21 – Mar 21 all-day

The month of February is recognized as Black History Month.

Feb 22 – Mar 22 all-day

The month of February is recognized as Black History Month.

Feb 23 – Mar 23 all-day

The month of February is recognized as Black History Month.

Feb 24 – Mar 24 all-day

February 2026 Feb 2026

Click the button below to download a PDF version of our Summer Day Camp signup form or complete the online form below:

Click here to download a PDF version of the form

Summer Day Camp Form

Child's Name:

Child's Name:

First

First

Middle

Middle

Last

Last

Parent(s) Name:

Parent(s) Name:

First

First

Middle

Middle

Last

Last

Address:

Home Phone Number:

Cell Number:

Place of Employment:

Work Number:

Church Affiliation:

Select One:

Male

Female

Date of Birth:

MM/DD/YYYY

Date of Enrollment:

MM/DD/YYYY

What is the age of the above child listed?:

Registration Fee:

Registration fee to be paid at church office, fee is $25 per child

Name of last school attended:

School address:

School phone number:

Emergency contact person(s) other than parent:

Name of Physician:

Physician's Phone Number:

Choice of Hospital:

Insurance Company:

This child will be released only into the care of the person(s) name appearing on this application, and or the following person(s):

This child will be released only into the care of the person(s) name appearing on this application, and or the following person(s):

First

First

Last

Last

Name

Name

First

First

Last

Last

By clicking the checkbox you agree to submitting this information to Bethlehem Missionary Baptist Church and verify that the above information is correct

I agree and verify the above information is correct

If you are human, leave this field blank.