Pentecost Children's Chapel Pre-Registration

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During the 10:30 am worship service on May 23rd at Eastern Shore Chapel, children age 3 through first grade will be invited to follow leaders to the outdoor chapel for a brief children's service.
Children and leaders will be required to wear masks, utilize hand sanitizer and maintain 6 feet of social distance as best they can.
Please direct any questions to our Director of Family Formation, Patti Glowatsky, at: pglowatsky@easternshorechapel.org or (757)348-1908.

Child's full name *

Child's preferred name *

Child's age and grade level (if in school) *

Parent or Guardian's full name *

Parent or Guardian's cell number *

Parent or Guardian's email address *

Address where the child resides *

Special information about your child (i.e. allergies, medications, special needs, interests, etc.) *

Option 1

Do you grant permission to Eastern Shore Chapel to use your child's photo in parish publications and electronic media formats? *

Yes

Parent or Guardian's Signature *

Submit

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