Theme image

Registracion del Participante

Go Back

Prince of Peace Lutheran Church

Location

8304 Old Keene Mill Rd

Springfield, VA 22152-1640

Map It

Contact Allison Smith:

703-451-5855

allison.smith@poplc.org

Primero, cuéntenos sobre usted:

Información de los Padres

Nombre

This field is required.

Apellido

This field is required.

Correo Electrónico

This field is required.

Would you like to be on the email list for Prince of Peace Children's Ministry Events throughout the school year?

This field is required.

Parent/Guardian #2 Email

This field is required.

Would Parent/Guardian #2 like to be on the email list for Prince of Peace Children's Ministry Events throughout the school year?

This field is required.

Teléfono de Contacto 1

This field is required.

Teléfono de Contacto 2

This field is required.

Dirección 1

This field is required.

Dirección 2

This field is required.

Ciudad

This field is required.

Estado/Provincia

This field is required.

ZIP/Código Postal

This field is required.

País

This field is required.

Afiliación de la iglesia local

This field is required.

Nombre del Contacto de Emergencia

This field is required.

Relación del Contacto de Emergencia

This field is required.

Teléfono del Contacto de Emergencia

This field is required.

Comentarios

This field is required.

Click here for your FREE Notes from Jesus Bundle

By checking the box you will be emailed your Free Notes From Jesus Bundle.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Cuéntanos sobre tu participante

Which session will they be attending?

Nombre

This field is required.

Apellido

This field is required.

Please select the Grade your child will be entering in the Fall of 2026.

Prince of Peace Music Camp participant spots are open to children entering Kindergarten through 6th Grade in the Fall of 2026. Children older than this are invited to register as a Music Camp Volunteer.

Grado Entrando

This field is required.

Género

This field is required.

Fecha de nacimiento

This field is required.

Talla de Camisa

This field is required.

Alergias

This field is required.

Preocupaciones Médicas

This field is required.

Has this child been baptized?

This field is required.

Does Prince of Peace have your permission to use your child's photograph in any of its publications, including both printed and digital?

This field is required.

Comentarios

This field is required.

— or —