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Parents' Night Out Childcare Signup
Parents' Night Out
Cornerstone Community Church
Friday, March 30th
6:00 - 9:00
Sign your kiddos up here if you need childcare for the Parents' Night Out evening. Childcare is available from 6:00 - 9:00. This is an Eggtastic Adventure for the kids with a glow in the dark egg hunt to wrap up the night.
Dinner and snacks will be available.
Name of Parent or Guardian *
Your answer
Child #1 Name & Age *
Your answer
Child #2 Name & Age
Your answer
Child #3 Name & Age
Your answer
Child #4 Name & Age
Your answer
Approximate time your child(ren) would need care:
Your answer
Email *
Your answer
Phone number (to reach you that evening) *
Your answer
Allergies or Important Health Concerns *
Your answer
MINOR ACTIVITY PERMIT: As a parent and/or guardian, I do herewith authorize treatment under the direction of any licensed physician of the following minor in the event of a medical emergency which, in the opinion of the attending physician, may endanger his or her life, cause disfigurement, physical impairment, or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me by phone provided during registration. The undersigned assumes the responsibility for any costs connected with such treatment and hereby releases the church where child attends Preschool Pathfinders from any liability. Date or dates when release is intended: September 1, 2017– May 31, 2018. This release form is completed and signed of my own free will with the sole purpose of authorizing medical treatment under emergency circumstances in my absence. *
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By checking this box, I am authorizing medical treatment under emergency circumstances in my absence.
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