Peace Making Kids - Vacation Bible School - Providence Presbyterian Church
 July 21-25th, 9 am until 12:30 pm
 We look forward to seeing you there!
 If you have any questions and would prefer not to fill out a registration form,  
 you can email the director here. To register via phone call Diane at 828-644-0799.

Student Name:
Student Age:
Date of Birth:
55/55/5555
Grade Completed:
Home Address:
Parent Names:
Home Phone:
(555) 555-5555
Mobile Phone:
(555) 555-5555
Other Contact:
Home Church:
Allergies/Concerns:
Emergency Contact:
Email:
Comments/Questions: