Child's Full Name
*
First Name
Last Name
Child's Date of Birth
*
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Child's Gender
Child's T-shirt Size
*
Please Select
XS (2-4T)
Youth S (6-8)
Youth M (10-12)
Youth L (14-16)
Youth XL (18-20)
Child's Favorite PBS Kids Show(s)
Parent's / Guardian's Full Name
*
First Name
Last Name
I am the child's:
*
Mother
Father
Grandfather
Grandmother
Aunt
Uncle
E-mail
*
example@example.com
Would you like to be added to our email list to be notified for any PBS Guam activities, events and promotions?
*
Yes, please!
No, thank you.
Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Mailing Address
*
Address Line 1
Address Line 2 (optional)
City
State / Province
Postal / Zip Code
How do you receive PBS Guam?
*
Online
Over the Air Broadcast
Cable
Membership
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PBS Guam Kids Club Membership
One-year membership to the PBS Guam Kids Club
$15.00
$
15.00
one-time payment
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