PCCSTUDENTMIN MINI LOCK-IN 2024

For all students 6th - 8th grade!

complete the form and then share with a friend!
A totally free and fun-filled night just for middle school students! All 6th-8th graders are invited--just complete the form below! There will be pizza, snacks, drinks, games, tournaments, karaoke, prizes and more.
PARENT/GUARDIAN NAME*

First NameLast Name
PARENT PRIMARY EMAIL*
PARENT/GUARDIAN Phone number*

Area CodePhone Number
Please type the name of the person or persons DESIGNATED to pick up your student from the lock-in by 1:30am AND their phone number.*
You may register more than one student as long as you are the parent/guardian.
STUDENT'S NAME*

First NameLast Name
Grade*
STUDENT'S NAME

First NameLast Name
Grade
STUDENT'S NAME

First NameLast Name
Grade
STUDENT'S NAME

First NameLast Name
Grade
I understand this event will take place at Pflugerville Community Church from 8:30pm - 1:30am. I understand my student must arrive between 8:30pm-8:45pm and that if they arrive AFTER 8:45pm, they will not be admitted (unless alternate arrangements were made in advance) I also understand I or the designated person must pick up my student by 1:30am.*

I agree
*I understand my student will be expected to respect leaders and fellow students during the duration of the event as well as follow all behavior guidelines given by the leaders. I understand I will be contacted and asked to pick up my student if he/she fails to do so.*

I agree
Should be Empty: