Bluffs & Bridges Program Interest
Thank you for your interest in our programs. We'd love to learn more about your young person! Space is limited in each program, and completing this form does not guarantee enrollment. Our team will contact you about availability and next steps.
Young Person Information
Participant Full Name
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First Name
Last Name
Preferred Name or Nickname (optional)
Date of Birth
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-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Age
*
Current School
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Current Grade
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Parent/Guardian Information
Parent/Guardian Full Name
*
First Name
Last Name
Relationship to Participant
*
Please Select
Parent
Guardian
Grandparent
Other
Email Address
*
example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Method
*
Call
Text
Email
Program Interest
Which Bluffs & Bridges program(s) are you interested in? (You may select one or both.) • Vicksburg Spotlight Initiative: A collaborative creative program where young people help create and produce an original public showcase, which may include theatre, film, storytelling, music, dance, or other creative work. • Echoes of Mississippi: A program where young people explore Mississippi history, culture, communities, and stories through research, travel, observation, and creative projects, ending in a public exhibit or presentation.
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Echoes of Mississippi-Begins: March 2027 Interest deadline: January 25, 2027
Vicksburg Spotlight Initiative -Begins: May 2027 Interest Deadline: March 22, 2027
About the Participant
What are some of your young person's interests? (Select all that apply.)
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Acting/Theatre
Film/Video
Photography
Music
Dance
Writing/Storytelling
Visual Arts/Design
History/Culture
Travel/Exploration
Technology/Behind-the-Scenes Production
Leadership/Community Projects
Other
Is there anything you'd like us to know about your young person, their interests, or what you hope they gain from participating? (Optional)
How did you hear about Bluffs & Bridges?
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School
Friend/Family
Social Media
Community Organization
Event
Website
Other
I understand this is an initial registration/interest form and that Bluffs & Bridges will contact me for additional enrollment information, permissions, releases, emergency information, and program-specific requirements as needed.
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I acknowledge and agree
Submit Registration
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