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Participant Registration

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Registro en Español

Salem Baptist Church

Location

199 Neal Kinsey Rd

Trenton, TN 38382

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Contact Todd Kirk:

731-855-2520

kirklikethecaptain@gmail.com

First, Tell Us About Yourself:

Parent Information

Attention! If you need to register your child for the nursery, Please contact Bro Todd. The Participant registration form on this site will not be available for nursery.

Nursery is only available for volunteers when they are present.

First Name

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Last Name

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Address 1

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Address 2

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City

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State/Province

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ZIP/Postal Code

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Country

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Contact Phone 1

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Contact Phone 2

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Emergency Contact Name

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Emergency Contact Relationship

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Emergency Contact Phone

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Click here for your FREE Friends With God Kids Activity Pack

By checking the box you will be emailed your Free Friends With God Kids Activity Pack.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Tell Us About Your Participant

First Name

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Last Name

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Grade Leaving

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Gender

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Date Of Birth

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Shirt Size

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Allergies

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Medical Concerns

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Do you have friends you would like to be placed with? We will do our best to group selected friends together in the same crew, but we cannot promise all requests will be possible.

Friend 1 First Name

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Friend 1 Last Name

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Friend 2 First Name

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Friend 2 Last Name

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Friend 3 First Name

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Friend 3 Last Name

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Comments

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