Bridge Street Ministries
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Grand Rapids Immersion Individual Registration

Step 1 of 3

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  • Please type your group leader's email address here so they get a heads up that you registered.
  • General Information

  • This information helps us determine sleeping arrangements.
    Select "Yes" if you will turn 18 before Immersion ends.
  • Background Check Information

    Please note that any adults working with or around children, youth, or adults with developmental disabilities are required to provide all of the following information, and consent to relevant background checks prior to their start date. All information provided in this application is secure and used solely by BSM staff for administrative purposes. Under no circumstance will the information provided be shared with an outside party.
  • Hidden
    Max. file size: 256 MB.
  • Emergency Contact

    Please provide contact information for the person we should call in case of an emergency.
  • Medical Information

    This information is required in case of an emergency. All information provided will be held in confidentiality.
  • Medications

    Please list medications and doses that are taken regularly.
  • MedicationDosageSpecific times taken each dayReason for taking 
  • Medication, Food, and Other AllergiesDescribe reaction and explain how it is managed 
    List all known
  • Release Form

  • Waiver

    for minors (under 18)
  • Waiver

    for adult students or leader (over 18)

Interesting links

Here are some interesting links for you! Enjoy your stay :)
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