PACM Convention Registration 2024

PENNSYLVANIA CHILDREN'S MINISTRY CONVENTION 2024 REGISTRATION FORM

Chaperone Registration

Chaperone Name *

First

Last

Phone *

Age *

Must be 18+ years old to register as a chaperone

Email *

How many children will you be registering? *

This price includes the tickets for the Afterburner @ Skyzone. If you wish to not purchase tickets to the Afterburner, you can register at the door for a reduced price of $50/child.

ADD UP TO 20 REGISTRANTS BELOW

Person #1

Name #1 *

First

Last

Person #2

Name #2 *

First

Last

Person #3

Name #3

First

Last

Person #4

Name #4

First

Last

Person #5

Name #5

First

Last

Person #6

Name #6

First

Last

Person #7

Name #7

First

Last

Person #8

Name #8

First

Last

Person #9

Name #9

First

Last

Person #10

Name #10

First

Last

Person #11

Name #11

First

Last

Person #12

Name #12

First

Last

Person #13

Name #13

First

Last

Person #14

Name #14

First

Last

Person #15

Name #15

First

Last

Person #16

Name #16

First

Last

Person #17

Name #17

First

Last

Person #18

Name #18

First

Last

Person #19

Name #19

First

Last

Person #20

Name #20

First

Last

LEADERSHIP INFORMATION

Layout

Pastor's Name *

First

Last

Church Name *

PAYMENT INFORMATION

Total *

$0.00

Credit Card *

Card

Name on Card