Quest Registration 2018-2019
Date: Second Sunday in October, November, January, February, March, and April
Time: 12:30 pm - 2:30 pm
Location: Cross Roads Community Church, 271 Main Street, Leechburg, PA
Contact us at 724-845-1901 or church@crcpc.org
Name *
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Birthday *
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Completed Grade Level *
Address *
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Parent/Guardian Name *
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Phone Number *
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Emergency Phone Number *
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Email Address
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Emergency Contact *
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Alternate Contact Phone Number *
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Medical Issues/Concerns
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Name of Person Picking up Child(ren) *
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Name of Home Church *
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