Poland Presbyterian Church
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    Middlers' Fun Day
    Registration & Release Form

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    Emergency Contacts:
    Please list anyone else who you authorize to pick up your child/ren in your absence, while in the care of PPC

    Privacy Information:
    All the information recorded on this form is collected and managed in accordance with the PPC Church Privacy Policy. This information has been collected for the primary purpose of PPC and may be used for any children's activities conducted or promoted by PPC.

    Permission to Participate in Program Activities:
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    Each child can bring one friend on May 15th, however, this form must be completed by the child's parent or guardian. Thank you!
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2 Poland Manor   •   Poland, Ohio 44514   •   330-757-1547