Middle School thru High School age appropriate
November 3rd ~ 4th, 6pm~8am
*DOORS OPEN FOR Registration at 5:30pm
PICK UP Time promptly at 8am
Help us raise funds for Hurricane Relief /$5 per youth
( All Proceeds/ Donations will go dIrectly to the Southern Baptist Convention ~
Designated to provide hot meals/necessities to recent Hurricane Victims)
PRE-Register Today!!!!
Child's First/ Last Name *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
School Grade *
Your answer
Email *
Your answer
Does Your Child Have Any Allergies? Please List If Any. *
Your answer
Any dietary restrictions? Please List. *
Your answer
Do we have permission to take your child off church premise?* *
(Team Building activities may be conducted at Lumberton Middle School within short walking distance of the church)
I would like to assist with the Lock-In
Would you like to assist the Next Generation Team of adults? - Please indicate how you would like to help with the evening.
Chaperone: All Nighter (6pm-8am)
Chaperone: Spend a few hours
Please contact me with specific Food/Treat contribution
I'll help with a Love Offering
Food/Treat contribution
Designated Love Offering: Southern Baptist Convention
Never submit passwords through Google Forms.
This form was created inside of Southside Baptist Church. Report Abuse - Terms of Service - Additional Terms