2019 Volleyball Registration

PCPC Volleyball Registration


Volleyball Payments are $150.00 per child for the entire season. When you register, you will receive an e-mail with a link to our secure online payment system that will enable you to make your payment.


First Name of Child #1
Grade Child #1
Child #1 Birthdate-Use MM/DD/YY
First Name Child #2
Grade Child # 2
Child #2 Birthdate-Use MM/DD/YY
Last Name*
Address*
City*
State*
Postal Code*
Contact Parent First Name
Contact Parent Last Name
Contact Parent Email*
Primary phone *(Cell/Mobile preferred)
From time to time, PCPC uses children's photographs to showcase or advertise programs and camps. Please check here to agree (or not) to allow your child's photograph to be used in any of these publications.

I/we do hereby release the staff and officers from liability of accident, illness or injury during his/her participation in the programs that my child is registered for at Palma Ceia Presbyterian Church. I/we authorize the persons presenting this form to call a physician and consent to any transportation, x-ray examination, anesthetic, medical or surgical diagnoses or treatment and hospital care which is deemed advisable for my/our child in case of emergency. It is understood that a conscientious effort will be made to notify me/us before such action is taken.

If you do NOT wish to consent to the medical and liability release, please contact Allison@palmaceia.org. Registration cannot be completed online.
REGISTRATION IS NOT COMPLETE UNTIL PAYMENT IS RECEIVED.
You will receive a confirmation email from donotreply@blackbaud.com shortly. Please secure your registration by clicking on the Pay Now link in the email you receive.
Palma Ceia Presbyterian Church 3501 San Jose St., Tampa, Fl 33629 Office: 813-253-6047 www.palmaceia.org


Are Required Fields