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Peace Memorial Presbyterian Church
Thursday, March 28, 2024
find peace
30 Spaces available for kids completed K-5th grade.
Older Children may serve as volunteers.
Please complete a separate form for each child you are registering.
Child's Name:
Preferred Name:
Grade Completed:
Birth Date:
Age:
Parent(s) Name:
Mailing Address:
City:
State:
AL
FL
GA
Zip:
Home Phone:
Home Email:
CARE PROVIDER INFORMATION (please provide two people to contact)
Name:
Relationship to Child:
Daytime Phone:
Cell Phone:
Name:
Relationship to Child:
Daytime Phone:
Cell Phone:
People who may pick up your child:
Does your child have food allergies:
No
Yes
List:
Medical Concerns:
No
Yes
List:
T-shirt Size: YOUTH S
YOUTH M
YOUTH L
YOUTH XL
ADULT S
ADULT M
ADULT L
ADULT XL
SIGN UP FOR:
Regular Program (9:00 am-2:00 pm) - $30
Special Interest Activity (choose one): Music
Art
Drama
Please provide any additional information that may be helpful to the staff of Peace Memorial concerning special circumstances involved with your child: