Bridge Kids Summer Club 2025 Registration
July 28 - 31, 2025 | Please fill out this form and click submit.
GUARDIAN INFORMATION
Name
*
Email
*
This address will receive a confirmation email
Phone
*
Address
*
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
PARTICIPANT INFORMATION
First Name
*
Last Name
*
Birth Date
*
Grade (By Fall 2025)
*
Emergency Contact Information (if other than guardian)
MEDICAL INFORMATION
Allergies or Medical Condition
Insurance Company and Policy Number
CONSENT OR RELEASE FROM LIABILITY
My child has permission to participate in Summer Club
*
Please select all that apply.
I agree
Bridge has permission to use photographs and/or videos for ministry and promotional purposes including websites. I understand I will not be paid or rewarded for providing this authorization.
*
Please select all that apply.
I consent
I am opting out
Submit
Description
July 28 - 31, 2025
Please fill out this form and click submit.
×
Please Fix the Following