Summer Slam 2017
Summer Slam is a chance for students entering 4th, 5th, and 6th grades to experience youth mission where they can serve Jesus by helping others.

Cost is $75.00. Includes meals, activities, t-shirt, and admission to Splash Kingdom.
If you any questions, please contact Rev. Nathan Firmin at nfirmin@longviewfumc.org, or 903-753-4463.

Child's Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
School
Your answer
Church Home
Your answer
Grade Completed
Allergies/Medical Concerns
Your answer
Current Medications
Your answer
Doctor's Name
Your answer
Doctor's Address
Your answer
Parent's/Gaurdian's Names
Your answer
Mom's Cell
Your answer
Dad's Cell
Your answer
Mailing Address
Your answer
Email Address
Your answer
Emergency Contact Name
Your answer
Emergency Contact Phone
Your answer
Who is authorized to pick child up?
Your answer
Shirt Size
Authorization and permission is hereby given by the undersigned to Summer Slam to photograph participant and use the photographs and likenesses of participant, including but not limited to newsletters, websites, or advertising.
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