top of page
Home
About Us
See & Do
Our Events
Vend Our Events
Celebrate Music Pittston
2nd Friday Art Walk Vendor Application
Farmers' Market Vendor Application
Get Involved
New Businesses
Contact
Blog
Pittston Playground Program
-Week Eight Registration-
AUGUST 4-8, 2025
Sorry, but we've reached our max capacity for this week.
Parent/Guardian First name
*
Parent/Guardian Last name
*
Parent/Guardian Email
*
Parent/Guardian Phone
*
Parent/Guardian Address
*
How many children are you enrolling in the program?
*
1
2
3
Child 1 Full Name
*
Child One Birthday
*
Month
Day
Year
Child 1 Gender
*
Male
Female
Child 1 Medical Conditions/Allergies
*
Is child 1 allowed to walk home
*
Yes
No
Child 2 Full Name
Child 2 Birthdate
Child 2 Gender
Male
Female
Child 2 Medical Conditions/Allergies
Is child 2 allowed to walk home
Yes
No
Child 3 Full Name
Child 3 Birthdate
Child 3 Gender
Male
Female
Child 3 Medical Conditions/Allergies
Is child 3 allowed to walk home
Yes
No
Full name of additional emergency contact:
*
Telephone # for additional emergency contact:
*
Playground Program Payment
Price Per Child
$25
Submit
bottom of page
