MS pumpkin patch Adventure | student registration

Sunday, October 20th, 2019

The Farm at Swan’s Trail, Snohomish, WA

Schedule: 10am - 4:30pm

Registration & Payment Deadline: Friday, Oct. 11th

Cost & Payment

Cost: $20

To ensure the costs of MS Pumpkin Patch Adventure are covered, this fee is non-refundable after the registration and payment deadline (Oct. 11). If you deide to cancel your student’s spot please contact us immediately.

Payments can be made online or by check.

Please mail or drop off checks to: Mercer Island Presbyterian Church 3605 84th Ave SE Mercer Island, WA 98040

Lunch & Arrival

The cost of the trip ($20) covers admission and transportation.

All students should bring a packed sack lunch or additional money for lunch on site. Students may also want to bring additional spending money for pumpkins (priced by size) and other treats. See more about The Farm’s food and activity options here.

We will leave MIPC at 10am.

Please arrive before 9:45am and check in with MIPC Youth staff. All parents are required to sign a permission release form at check in.

Medical Form

An up-to-date medical information form and release is needed for each student that participates in activities with MIPC Youth Ministries.  

If you already submitted an up-to-date online medical form during the 2019-2020 school year for LIVE or another event, you do not need to re-submit.


Date of Birth *
Date of Birth
Student Cell *
Student Cell
Home Phone *
Home Phone
Parent/Guardian 1 Name *
Parent/Guardian 1 Name
Parent/Guardian 1 Cell *
Parent/Guardian 1 Cell
Parent/Guardian 2 Name
Parent/Guardian 2 Name
Parent/Guardian 2 Cell
Parent/Guardian 2 Cell
Medical *
I have submitted an up-to-date Medical Information Form for my child for the 2019-2020 school year.
We don't ever want money to be a barrier for your/your student's involvement! Scholarship money is available to assist students and families with program and event payments who would otherwise be unable to participate due to financial reasons. We ask that you would pay as much as you are able, so that we are able to assist as many families as we can. All requests are confidential.
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