Belin Memorial Children’s Lenten Studies Registration & Medical Form

Children learning the true meaning of why we celebrate Easter. Starts Tuesday’s March 19 through April 9, 2019 (four weeks). Open to kindergarten - 5th Grade

Child's Name *
Child's Name
(Other than Parents)
Photography and Video Release
List any allergies or behavioral, or medial concerns that we should know about that may affect your child's participation in Children's Lenten:
Name of Pediatrician:
Pediatrician's Phone Number:
AUTHORIZATION *