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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:

   
 


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