Bible Class or L2L Registration Bible Class or L2L Registration For more information: Phone: 254-752-0543 Email: lrose.newroadcoc@gmail.comParent InformationParent Information(Required) First Last Email Phone(Required)Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Child InformationHow many children do you want to register?(Required) 1 2 3 Child 1Name First Last Child's Birthdate(Required) MM slash DD slash YYYY Current School Grade(Required)PreschoolKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeChild 2Name First Last Child's Birthdate(Required) MM slash DD slash YYYY Current School Grade(Required)PreschoolKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeChild 3Name First Last Child's Birthdate(Required) MM slash DD slash YYYY Current School Grade(Required)PreschoolKindergarten1st Grade2nd Grade3rd Grade4th Grade5th GradeAdministrativeIs the Emergency Contact same as parent above?(Required) Yes No Emergency Contact Name(Required) First Last Emergency Contact Phone(Required)Does child have any special needs?(Required) Yes No Please tell us about your child's special needs.(Required)CAPTCHACommentsThis field is for validation purposes and should be left unchanged.