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Molokai 5-Day Club Registration 2022
Thank you for your willingness to host a 5-Day Club in your community June 13-17 on Molokai. Please complete this short registration form so we know when and where you would like to have your club.
Host Contact Information & Responsibilities
Name
*
First Name
Last Name
Email
*
Verify Email
*
Phone
*
Club Advertising and Promotion
*
The success of your club depends on getting the word out to families with children in your community. We depend on our hosts and/or their churches to do all of the advertising and promoting for their 5-Day Club. Please indicate that you are willing accept this responsibility.
Agree
Disagree
Will You Provide Snacks for Your 5DC?
The snacks can be as simple or elaborate as you like. This is also a great way to have others in your church participate by volunteering to provide snacks on a given day for the club. Please indicate that you are willing accept this responsibility.
Yes
No
Not sure yet.
Club Registration
*
We want the children who attend your club to have a personal connection with a local church in their community. One of the best ways to create this opportunity is for you and your church to provide a volunteer each day of the club to register the children who attend and follow-up with those children after the 5-Day Club is over. Please indicate that you are willing accept this responsibility.
Agree
Disagree
Church Information
We prefer to have every 5DC also have a local church sponsor. Even if the 5DC is not held at a church, we would like you to invite your church to participate and help follow up with children and their families when they receive Christ.
Church Name
*
Pastor's Name
Pastor's Phone
Pastor's Email
Verify Email
5-Day Club Information
Club Location Type
*
Church
School
Park
Backyard
Community Center
Other
Club Location Type
*
If you selected other, please indicate what type of location your club will be held at here.
What is the physical address for your 5DC location?
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Island
*
select one
Big Island
Maui
Oahu
Kauai
Molokai
Lanai
Niihau
Kahoolawe
When would you like to start your 5DC?
*
Please choose your preferred start time. If you know your location is farther away from Molokai Baptist Church than 15-20 mins, please select one of the later time slots if possible.
select one
1:00 p.m.
1:30 p.m.
2:30 p.m.
3:00 p.m.
3:30 p.m.