Lab Registration – Bridge Street Ministries

Resurgence Lab Registration

Marking Period 1

Student Name*
First Last
Parent/Guardian Name*
First Last
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Emergency Contact Name*
First Last
Emergency Contact Phone*
Lab Offerings*
Select the lab(s) you would like to register your student for:
- Young Money Finances - MONDAYS 9/28 - 10/26 | 2:30-4 PM
- Bible Lab - TUESDAYS 9/29 - 10/27 | 2:30-4 PM
- ACT Photo Media - WEDNESDAYS 9/20 - 10/28 | 2:30-4 PM
- Blandford Nature Center - THURSDAYS 1/10 - 10/29 | 2:30-4 PM
- Resurgence Mentoring - FRIDAYS 10/2 - 10/30 | 2:30-4 PM
Consent*
I am a parent or legal guardian of the student listed above, and hereby consent to the terms listed on this form.
Transportation from school, to labs, and drop-off at home is provided by Bridge Street Ministries and available for all registered Resurgence students. Students will be dropped off at the address listed above unless otherwise instructed by a parent or legal guardian. By checking this box, you are authorizing Bridge Street Ministries (BSM) to provide transportation for the student listed above during the duration of this lab. This form grants Bridge Street Ministries permission to use my/our child's photos in any of their promotional advertisements.

Space is limited. Please only register if you can attend every lab.

Resurgence is an after-school program developed specifically for students at Westwood Middle School by focusing on academic, social, spiritual and community development. Resurgence is a program of Bridge Street Ministries (BSM), a Christ-centered non-profit ministry in West Grand Rapids. Contact us at bsmgr.org | info@bsmgr.org