Date of loss(Required)

Does Bethlehem Assembly of God - GriefShare Support Group have permission to take your picture or use a recorded video of your grief journey for promotional purposes as a testimony for others?(Required)

Bethlehem Assembly of God is attempting to do a better job at tracking those who participate in our programs such as GriefShare. By agreeing below, you grant permission for us to enter the pertinent information on your and/or your child(ren) into our data(Required)

I understand that Bethlehem Assembly of God GriefShare is not a clinical, therapeutic or mental health program but a Biblical based Christ Centered Program to help deal with loss in a group setting.(Required)

Registration Fee(Required)