2019 VolleyKids Registration

PCPC VolleyKids Registration


Volleyball Payments are $120.00 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)

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