Youth’s Name __________________________________________

Address________________________________________________

City, State, Zip___________________________________________

Parent(s) Name ____________________________

Highest Grade Completed ______________________

Please enclose a check for $20 dollars for each child to cover cost of activities.
Make checks payable to: Presbytery of Southwest Florida - GA 2000

Mail:
One registration for each child
One permission form for each child
$20 per each child

To: Bea Panagotopulos, 1621 Summit Way, Dunedin, FL 34698