Last Name

First Name

Check if you are:

Street Address

City

State

Zip Code

Phone Number (w/area code)

Email Address

Name of Church

# of Jr. High to attend:

# of Sr. High to attend:

# of Adults to attend:

Will you be staying for lunch on Sunday at 12:00 p.m.?

All children will be required to submit a medical release form before or at registration. If you cannot print this form, you may also request it by calling 731-352-4030 or emailing admissions@bethelu.edu.

To view the 2010 schedule, click here.