St Peterís by The Sea Presbyterian Church

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St. Peter's by the Sea Presbyterian Church

Easter Project 2019

March 31, 2019 - April 5, 2019

* Denotes a required field to fill in
Participant's First Name*
Participant's Last Name*
Address*
Address Line 1 
Address Line 2 
City     State     Zip 
Birthdate*  
Do you have a current passport?*
Yes
No
Current grade
T-shirt size
Have you completed the required forms for Amor?   Clear My Answer
Yes
No
Are you registering more than one participant from your family?  If so, please select if this registration is the first, second or third, etc. from the drop down.  If you are only registering one, select First participant from the drop down.*
Parent/Guardian First Name*
Parent/Guardian Last Name*
Phone (including area code)*
Email*
Verify Email*
Emergency Contact Name*
Relationship to child*
Phone #1*
Phone #2
Allergies or Special Needs. Enter None or N/A if this does not apply.*
Name of Physician
Physician Phone Number
Medical Insurance Company & Policy Number
Tent Mate Preference (list one or two friends and we'll do our best to put you with one of them).

RELEASE AGREEMENT REQUIRED:


Acceptance:* 
Full Name:*