Love Bolivar 2026
April 25, 2026 | Please complete the form below to register for Love Bolivar 2026 and click "Submit" when finished.
Name
*
Email
*
This address will receive a confirmation email
Phone
*
Which area would you like to serve during Love Bolivar?
*
Please select one option.
Blessing First Responders
BHS Blessing Bags
City of Bolivar - City Cleanup
City of Bolivar - Parks and Recreation (THIS GROUP IS FULL)
Community Outreach Ministries
Parkview Health Care Facility (THIS GROUP IS FULL)
Southwest Baptist University
Oil Change - Sign Holders
Oil Change - Check-In Station (THIS GROUP IS FULL)
Oil Change - Runners
Oil Change - Childcare
Oil Change - Hostess
Oil Change - Other (Only select this if directed by Ted Costello, Brent Epp, or the Church Office)
Please list the names of all individuals you are signing up who will serve in this area (including children).
*
Please list each person's T-Shirt size. (Sizes available: Youth XS-XL, Adult S-5X)
*
Payment
1 Person ($10)
2 People ($20)
3 People ($30)
4 People ($40)
5+ People ($50)
Paying via Cash/Check ($0)
1 Person ($10)
2 People ($20)
3 People ($30)
4 People ($40)
5+ People ($50)
Paying via Cash/Check ($0)
Amount
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
April 25, 2026
Please complete the form below to register for Love Bolivar 2026 and click "Submit" when finished.
×
Please Fix the Following