PCC Kid Picks Event Request Form

To request a PCC Kid Picks event, please fill out the following form. Please note that we must receive your application at least eight weeks before the requested date of your event.

(* indicates a required response)

Name:	*
Primary phone:	*
Second phone:
E-mail:	*
Name of school or location  of event:	*
Exact street address of event location:	*
City, state and zip code of event location:	*
Date of event:
Number of children participating:
Age range of children:
Comments: