Pelham Church of God - Pelham Students Parent Form

STAY CONNECTED

By filling out this form you will receive updates for you and your teenager to get involved with all things Pelham Students! This includes our local events, pricing updates for Pelham Students events, fun activities, & more!

Parent Information (required)

First Name

Last Name

Email

Phone Number

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Student Information (required)

First Name

Last Name

Birthdate

Grade

School 1

Gender

Student #2 (required)

First Name

Last Name

Birthdate

Grade

School 2

Gender

Student #3 (required)

First Name

Last Name

Birthdate

Grade

School 3

Gender

Student #4 (required)

First Name

Last Name

Birthdate

Grade

School 4

Gender