Pax Christi VBS Registration Form
June 21 to 22 from 6-8:30PM
June 23 from 10AM-noon
Our Mother of Sorrows Gym
774 Eastern Parkway
K to 5th Grade
No cost, just fun!
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name
Your answer
Address *
Your answer
City/State *
Zip Code *
Your answer
Email *
Your answer
Phone Number *
Your answer
Phone Number
Alternate Phone Number
Your answer
Emergency Contact *
Name
Your answer
Emergency Contact *
Relation to child/children
Your answer
Emergency Contact *
Phone Number
Your answer
People Who May Pick Up Child/Children *
Please include name and relation to child
Your answer
Next
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