2344 CENTER STREET, BETHLEHEM, PA 18017TEL: 610-867-5865 WWW/FPC-BETHLEHEM.ORG

STUDENT REGISTRATION FORM

STUDENT’S NAME_____________________________________________________o HIGH SCHOOL STUDENT/GRADE IN FALL________ o MIDDLE SCHOOL STUDENT/GRADE IN FALL________

PARENTAL RELEASEI give my permission for my son(s)/daughter(s) to participate in and to receive transportation provided by the church for:

o YCX MINI GOLF AT OASIS/JULY 6 (MIDDLE SCHOOL STUDENTS)o SNL POOL PARTY AT EVERTS/JULY 10 (HIGH SCHOOL STUDENTS)o HIGH SCHOOL NIGHT ON THE MOVE/AUG 19 & 20 (COST IS $30.)

I release First Presbyterian Church of Bethlehem, PA, its trustees, employees or agents from any liability. I understand that attendance youth programs for my son(s)/daughter(s) is a privilege. I accept responsibility for his/her/their behavior and understand that I may be called at any time during the program(s).

MOTHER’S NAME*_____________________________________________________

FATHER’S NAME*______________________________________________________

STUDENT ADDRESS*___________________________________________________

CITY/STATE/ZIP CODE_________________________________________________

PARENT’S PREFERRED E-MAIL*_________________________________________

STUDENT’S PREFERRED E-MAIL*_______________________________________

____________________________________________________________________PARENT’S SIGNATURE DATE

____________________________________________________________________PHONE NUMBER WHERE PARENTS CAN BE REACHED DURING EVENTS

SUMMER KICK-OFF Cook-out! We will supply the hot dogs, hamburgers, and drinks. You bring a blanket or chair and a picnic food/dessert to share!

SERVICE NIGHT We will spend some time doing some great work projects at the church. Wear your best work clothes.

POOL PARTY AT THE EVERTSWe will meet at the Evert’s, 2708 Bridle Path Place. Please bring a swimsuit and towel. (Register online or complete the form on back.)

WATER KICKBALL & WATER GAMES Wear a swimsuit and bring a towel and change of clothes.

BEST NIGHT OF THE WEEKGames, food and Bible Study

SUMMER KICK OFF AND COOK OUT! We’ll provide hot dogs, hamburgers and drinks. You bring a blanket or chair and a picnic food/dessert to share!

SERVICE AND SLUSHIES We will spend time doing some great work projects here at the church and enjoy some slushies following our work! Wear work clothes.

MINI GOLF AT OASIS Meet at Oasis Mini Golf on Schoenersville Road at 6:30 p.m. Please bring $10 (cash) for golf and snacks. Pick up at Oasis at 8:30 p.m. (Register online or complete the form on back.)

FLOATS AND A FLICK Join us for a movie and ice cream floats

H2OHHH!!! WATER NIGHT Outrageous water games including water slide kickball! Wear a swimsuit and bring a towel and a change of clothes.

GAME NIGHT Great games for all!

END OF SUMMER PARTY End of summer fun–games, gaga, snacks, crafts and more! We will be filling the backpacks with all the school supplies we are collecting all summer and getting them ready to deliver.

JUNE 15

JULY 06

JUNE 29

AUG 17

AUG 10

JULY 13

AUG 03

JULY 20

MIDDLE SCHOOL (COMPLETED GRADES 5–8)Wednesdays from 6:30–8:30 p.m. on the back lawn. Join us for great activities, service, Bible Study, fellowship, food & fun! Friends are welcome!!

SUMMER YCX

JUNE 12

JULY 10

JUNE 26

AUG 14

JULY 17

HIGH SCHOOL (COMPLETED GRADES 8-12) Join us Sunday Nights from 6:30-8:30 on the back lawn for great activities, service, Bible Study, fellowship, food & fun! Friends are welcome!!

SUMMER SNL

AUG 07

JULY 31&

BRING A NEEDED SCHOOL ITEM! OUR ONGOING SUMMER MISSION PROJECT WILL BE COLLECTING SCHOOL SUPPLIES. EVERY TIME YOU COME TO SUMMER YCX BRING A NEEDED SCHOOL ITEM. AT THE END OF THE SUMMER WE WILL PACK THEM INTO BACKPACKS AND DELIVER THEM TO DONEGAN.

ZOMBIE PLANET The great zombie planet game taken outside!

AUG 20

AUG 19&

NIGHT ON THE MOVE SPECIAL EVENT IT WILL BE SO MUCH FUN, YOU WON’T WANT TO MISS! BRING A SLEEPING BAG AND PILLOW, BATHING SUIT (NO SPEEDOS OR BIKINIS), SWEATSHIRT, OVERNIGHT ESSENTIALS AND A FLASHLIGHT. MEET IN THE COMMONS AT 8:00 P.M. TO DROP OFF YOUR STUFF & WE WILL BEGIN OUR NIGHT! COST IS $30. REGISTER BY AUGUST 1.

SUMMER SEND-OFF

8 PM–9 AM

MISSION PROJECT 2016