Explore Bethany Membership Thank you for completing our Explore Bethany Membership form. Please enter the following fields, and click on the Submit button when you are finished. Be sure to indicate whether you can attend the Explore dinner on Oct 25, 6 - 8 PM.Your Name(s)*We only need one form per family, so you can enter multiple names in this field.Your Preferred Email Address* We will use this email address to confirm your attendance at the dinner.Your Preferred Phone*To contact you directly, in cases were email is not is not the best method of communication.I can attend the Dinner on Oct 25*YesNo, but I am still interested in MembershipNo, I am not interested in Membership at this timeI will need Child Care for the Dinner on Oct 25*NoYesIf Child Care is required, how many children will you be bringing?Please enter a number from 0 to 10.If attending the dinner, please list any dietary restrictions you might have.Please list any other questions or comments you might have.EmailThis field is for validation purposes and should be left unchanged.