2009 Peace School Registration

You can either fill out the form below and click the button to submit it online, or click on the following links to download and print the PDF or Word document and mail it to us. We look forward to working with you and your child!

Adult's Name

Relationship to Child (parent, grandparent, guardian)

Mailing Address

Daytime Telephone

Email (for confirmation)

If participating adult is not child's parent or guardian, please provide the following information:

Parent's name

Parent's telephone numbers (if not accompanying child)

Parent's address

If reasonable attempts to contact you (parent) are made, do we have permission to transport your child to the hospital?

If so, to which hospital?

Child 1: Name

Child 1: Age

Child 1: School grade completed

Child 1: Medications or Health information

Child 2: Name

Child 2: Age

Child 2: School grade completed

Child 2: Medications or Health information

Child 3: Name

Child 3: Age

Child 3: School grade completed

Child 3: Medications or Health information

Does anyone in the family have any food allergies or restrictions? If so, please describe.

Will daycare be needed for a child that has not completed kindergarten?

The cost is $10 per person or a discount for a family of three or more at $25.

Will you mail your fee to the ICP office or pay on the day of the event?

A limited number of scholarships may be available for low-income families. Do you need to request a scholarship?