LIGHT CENTRAL Organization Partnership & Program Interest Form
This form gathers essential information regarding your organization/program and your interest in partnering with Light Central for various activities and services. Please answer all questions to the best of your ability.
Sign in to Google to save your progress. Learn more
Email *
About Light Central
Light Central is a creative community hub designed to provide safe, engaging, educational, and uplifting experiences for people of all ages. We welcome children, youth, teens, young adults, adults, families, seniors, schools, churches, nonprofits, mentorship programs, community organizations, and outreach groups.

Our mission is to create a safe environment where people can create, learn, connect, grow, heal, and discover purpose through creativity, mentorship, workshops, recreation, faith, and community engagement.

Programs and experiences may include creative labs, workshops, slime experiences, game room activities, life skills development, mentorship, Bible studies, social connection, and community resource support.
Organization/Program Name *
Primary Contact Person *
Position/Title *
Phone Number *
Email Address *
Organization Website/Social Media *
Organization Address *
City/State/Zip *
Which group(s) will you be bringing? (Check all that apply) *
Required
Age Range(s) of Participants (Check all that apply) *
Required
Tell us about your organization/program and the people you serve: *
Average Number of Participants Expected Per Visit *
Average Number of Staff/Chaperones Attending *
Which activities/services are you interested in? (Check all that apply) *
Required
How would you like your sessions structured? (Check all that apply) *
Required
Session Frequency Requested (Check all that apply) *
Required
Preferred Session Length *
Required
Preferred Days (Check all that apply) *
Required
Preferred Time Frames (Check all that apply) *
Required
What would you like your group to gain from this experience? *
What are some areas where your program/group would like additional support, growth, or development? *
Are there any special accommodations, behavioral considerations, allergies, or support needs we should be aware of? *
Location
Light Central
4325 Troost Ave, Suite 200
Kansas City, MO 64110
(816) 256-1506
Lightwerkkc@gmail.com

Hosted by Light WerK LLC & Christ Time Ministry Inc.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms