Volunteer Middle School Adventures Registration 2019
July 15th - 19th, 2019 at the Londonderry Town Hall (139 Middle Town Road)

Sign up your Students for Kids Club (no additional paper work required).

It's lots of fun and completely free! We'll be meeting every morning from 9:30am - 12:00pm.

​Middle School Adventures is for students 4th grade completed through 8th grade completed.

Please sign up each child separately.

First Name *
Your answer
Last Name *
Your answer
Birthday *
MM
/
DD
/
YYYY
Gender *
Allergies, Medical Information, Special Needs
Your answer
T-shirt Size *
Home Address *
Your answer
Primary Phone Number *
Your answer
Work Phone Number
Your answer
Email Address *
Your answer
Emergency Contact Name (1) *
Your answer
Emergency Contact Phone Number (1) *
Your answer
Emergency Contact Name (2) *
Your answer
Emergency Contact Phone Number (2) *
Your answer
Do we have permission photograph you? *
Do we have permission to use your photograph in church publications? *
Permission
I understand that there are inherent risks involved in any event, and hereby release First Baptist Church, its staff and volunteer workers from any and all liability due to an injury, loss or damage to person or property that may occur during the course of this trip.

I understand that I maybe asked to transport students in my personal, a rental, or other vehicles.

By clicking "I agree" below, you are agreeing the statements above.

Permission Agreement *
Required
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