A Night in Bethlehem
for Families with children 3 – 10 years old
December 15th from 7-8 pm
in the Fr Kline Social Center
Cost is $5 per child

Online Registration and Payment must be in
by December 9th!

REMEMBER TO BRING
A NON-PERISHABLE ITEM

TO “PAY YOUR TAXES”

Online Payment is required
to complete your Registration.
NOTE: Unused reservations cannot be refunded.

A Night in Bethlehem Registration Form

An asterisk indicates required information

Last Name

Child/Children Names and Ages

First Name & Last Name
First Name & Last Name
First Name & Last Name
First Name & Last Name

Registration Fee is - $5 per Child
Online Payment is required to complete registration

Number of Children registered *
Total Due

To submit your responses on this form: Check - I’m not a robot and complete the task. A green check will appear when completed correctly.

Next click SUBMIT. Wait to see the message that your information was sent.
Then click the button below to pay your Fee.

Total Due

You may make payment by credit or debit card online after you Submit this form