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EBC Student Lock-In

Get ready for an unforgettable night! Ebenezer Baptist Church is hosting our annual Teen Lock-in on Friday, October 9th starting at 8:30PM at 2570 Harbins Rd, Dacula, GA 30019.

This event is FREE and open to all students in grades 6-12.

Please check out the Parent's Guide for all the details on what to bring and event expectations. .

Fill out the form below to register. We can't wait to see you there!

Student Information

How many students are you registering?

First Name

Last Name

Grade

Address

Parent/Guardian Information

Parent/Guardian Full Name

Parent/Guardian Phone Number

Parent/Guardian Email

Emergency Contact

Emergency Contact (Secondary, if parent is unreachable)

Emergency Contact Phone Number

Health & Safety

Food Allergies or Dietary Restrictions

Consent

Liability Waiver & Permission

I give permission for my student to attend the Teen Lock-in event on October 9th. I understand the activities involved and release the organization from liability.

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