Grand Rapids - The Salvation Army Kroc Center


<div class="wp-block-genesis-blocks-gb-columns gb-layout-columns-1 one-column gb-columns-center"><div class="gb-layout-column-wrap gb-block-layout-column-gap-0 gb-is-responsive-column" style="max-width:900px">
<div class="wp-block-genesis-blocks-gb-column gb-block-layout-column gb-is-vertically-aligned-center"><div class="gb-block-layout-column-inner" style="margin-bottom:20px;text-align:center"><figure class="aligncenter wp-block-post-featured-image"><img loading="lazy" decoding="async" width="2560" height="1702" src="https://cms.grkroccenter.org/wp-content/uploads/sites/2/2026/09/LPGIG-Web-Header-scaled.jpg" class="attachment-full size-full wp-post-image" alt="" style="width:100%;height:100%;object-fit:contain;" srcset="https://cms.grkroccenter.org/wp-content/uploads/sites/2/2026/09/LPGIG-Web-Header-scaled.jpg 2560w, https://cms.grkroccenter.org/wp-content/uploads/sites/2/2026/09/LPGIG-Web-Header-300x199.jpg 300w, https://cms.grkroccenter.org/wp-content/uploads/sites/2/2026/09/LPGIG-Web-Header-1024x681.jpg 1024w, https://cms.grkroccenter.org/wp-content/uploads/sites/2/2026/09/LPGIG-Web-Header-768x511.jpg 768w, https://cms.grkroccenter.org/wp-content/uploads/sites/2/2026/09/LPGIG-Web-Header-1536x1021.jpg 1536w, https://cms.grkroccenter.org/wp-content/uploads/sites/2/2026/09/LPGIG-Web-Header-2048x1362.jpg 2048w, https://cms.grkroccenter.org/wp-content/uploads/sites/2/2026/09/LPGIG-Web-Header-600x400.jpg 600w" sizes="auto, (max-width: 2560px) 100vw, 2560px" /></figure>


<h2 class="wp-block-heading">Interested in your teen participating in L.P.G.I.G.? Please fill out the form below.</h2>



<div class="wp-block-kroc-free-text-area section"><div class="container"><script>
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Last)</span><span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_6_6' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><div id="field_6_12" class="gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-group-id="6a617ce5" data-field-span="6"><label id='gfield_label_6_12' class='gfield_label gform-field-label' for='input_6_12'><span class='gform-field-label__text'>Parent/Guardian Phone Number</span><span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_phone'><input name='input_12' id='input_6_12' type='tel' value='' class='large'  placeholder='(999) 999-9999' aria-required="true" aria-invalid="false"   data-mask="(999) 999-9999" /></div></div><div id="field_6_8" class="gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-group-id="6a617ce5" data-field-span="6"><label id='gfield_label_6_8' class='gfield_label gform-field-label' for='input_6_8'><span class='gform-field-label__text'>Parent/Guardian Email</span><span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_6_8' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><div id="field_6_9" class="gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-group-id="816d88a9" data-field-span="12"><label id='gfield_label_6_9' class='gfield_label gform-field-label' for='input_6_9'><span class='gform-field-label__text'>Emergency Contact Name</span><span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_6_9' type='text' value='' class='large'     aria-required="true" aria-invalid="false"   /></div></div><div id="field_6_13" class="gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-group-id="dccd26cc" data-field-span="6"><label id='gfield_label_6_13' class='gfield_label gform-field-label' for='input_6_13'><span class='gform-field-label__text'>Emergency Contact Phone Number</span><span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_phone'><input name='input_13' id='input_6_13' type='tel' value='' class='large'  placeholder='(999) 999-9999' aria-required="true" aria-invalid="false"   data-mask="(999) 999-9999" /></div></div><div id="field_6_10" class="gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible" data-group-id="dccd26cc" data-field-span="6"><label id='gfield_label_6_10' class='gfield_label gform-field-label' for='input_6_10'><span class='gform-field-label__text'>How did you hear about the program?</span><span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_select'><select name='input_10' id='input_6_10' class='large gfield_select'    aria-required="true" aria-invalid="false" ><option value='Flyer' >Flyer</option><option value='Social media' >Social media</option><option value='Staff' >Staff</option><option value='Word of mouth' >Word of mouth</option></select></div></div></div></div>
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L.P.G.I.G. (Living Proof God is Good)

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L.P.G.I.G. (Living Proof God is Good)

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Thanks for your interest in Kroc Center membership.

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