Grades K4-K5: PHPC VBS 2025 Upward Bound Registration - June 16-20

This form is for children who will complete K4 or K5 by Summer of 2025.

Child's Name

Child's Date of Birth

Address

Allergies

Shirt Size

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/Guardian)

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

Where did you hear about our VBS?

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

Description

Mon-Fri, June 16th -20th , 9am - 12pm

Please fill out this form and click submit.