PHPC VBS 2022 Summer Space Probe Registration

June 13-17, 9am - 12pm | Palmetto Hills Presbyterian Church
K4 - 5th grade (completed)

Child's Name

*

Child's Date of Birth

*

Address

*

School Grade will have completed by summer 2022 (children must have just completed grades K4-5th)

*

Please select one option.

K4 K5 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade

Allergies

Shirt Size

*

Please select one option.

Youth xsmall (4-5) Youth small (6-8) Youth medium (10-12) Youth large (14-16)

Parent's Email

*

This address will receive a confirmation email

Parent/Guardian Full Name

*

Parent/Guardian Phone Number

*

Emergency Contact Full Name (different from Parent/Gaurdian)

*

Emergency Contact Phone Number (will only use if Parent/Gaurdian can not be reached)

*

Where did you hear about our VBS?

*

Please select one option.

School Flyer Community Advertising/Sign Friend or Family You are a current member or visitor of PHPC

Description

June 13-17, 9am - 12pm

Palmetto Hills Presbyterian Church
K4 - 5th grade (completed)

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