july, 2024 This is a repeating eventjuly 9, 2024 6:30 pmGrace Gospel Church214 Falcon Ave, Patchogue NY 11772 08jul6:30 pm9:00 pmSummer AdventureFree Summer Adventure for kids who completed K-6 - 6:30-9pm6:30 pm - 9:00 pm 214 Falcon Ave, Patchogue NY 11772 Event Details Event Details Summer Adventure Registration Form Child's Name* First Last Child's Date of Birth* Month Day Year Last Grade Completed* Parent/Guardian Name* First Last Parent/Guardian Cell Phone*Home Phone*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Enter Email Confirm Email Emergency Contact Name* First Last Emergency Contact Phone*Medical or other information we need to know about your child (Please include all allergies). If there are none please write N/A in the box below*Dismissal Information - Who may pick up your child at the end of each night?* Time (Monday) 6:30 pm - 9:00 pm LocationGrace Gospel Church214 Falcon Ave, Patchogue NY 11772 CalendarGoogleCal
