Parents' Night Out Registration Form
Date of Event:	Please Select a Date March 20, 2010
Names of Parents:
Names of Children:		Ages:
Known Allergies:
The cost for this event is $5.00 per child. It is open to children ages birth-5th grade. The times are 6:00 – 8:30 pm. We will serve pizza for dinner. For more information please call the church at (704)289-3186, or contact Mary Ann Burns.