4th and 5th Grade Fall Party
Our 4th and 5th graders are invited to a FALL PARTY! We'll roast hot dogs, play games and make s'mores! 

Date: Saturday, October 22, 2022
Time: 5:00-7:00 PM
Where: The Breneman House
Address: 151 Church Road, Manheim PA 
RSVP by: October 19
Questions: email stephanie@encounterchurchofpalmyra.org


Sign in to Google to save your progress. Learn more
Name of Student *
Parent/Guardian Name *
Email *
Phone Number *
Dietary restrictions/food allergies
(If none, you may skip to the next question)
Insurance Information 
(Insurance carrier and member ID)
 *
By submitting this form, the parent/guardian gives the student listed above permission to attend the Fall Party at the home of Nate and Amy Breneman and waives all claims against Encounter Church of Palmyra, its employees and volunteers in the case of accident or injury during participation of this event. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms