Conowingo Baptist Church

Event Information
Event

Winter Jam 2023

Location
Santander Arena 700 Penn St, Reading, PA 19602

Event Date
2/23/23

Departure Time
1:00PM

Arrival Time
12:00AM

Details

Christian Concert
Bring money for food and merch

*Students will have to leave school early to make this event*

Cost Per Child
$20

Cost Per Chaperone
$20

Due Date
2/16/23
Student Information
Student 1 First Name*
Student 1 Last Name*
Student 2 First Name
Student 2 Last Name
Parent Information
Parent / Guardian First Name*
Parent / Guardian Last Name*
Phone Number
Will you be participating as a Chaperone?*

I cannot attend.I cannot drive, but I am available to chaperone.I will chaperone and transport my student and xx amount of students in my care.
Please indicate the number of students you can transport*
Emergency Contact Information
Name
Relationship
Phone Number
Medical Information
Important Medical Information The Supervisor Should Know
Authorization Signature
By signing below, I acknowledge that I have read, understand, and agree to the Terms and Conditions listed above.Furthermore, I certify that I am the Parent or Legal Guardian of the student named above and that all the information provided is true and correct to the best of my knowledge.
Parent/Guardian Signature*
Conowingo Baptist Church

151 Rock Springs Rd

Conowingo, MD 21918
Should be Empty: