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Parents Night Out Registration Form
If you are registering multiple children, you will need to fill out the form out once for each child.
This Event will be held at Chief Sealth International High School
Registration ends: APRIL 24TH
* Indicates required question
Email
*
Record my email address with my response
Name of Child (First and Last)
*
Your answer
Age of Child
*
Your answer
Name of Parent/Guardian
*
Your answer
Parent/Guardian Phone Number
*
Your answer
Name of Additional Emergency Contact/Relation to Child
*
Your answer
Additional Emergency Contact Phone Number
*
Your answer
Allergies, Medications, Other Medical Alerts or Concerns
Your answer
Childs preference of Pizza
*
Cheese
Pepperoni
Either
My Child has allergies/will bring their own dinner
Every child is different. If your child becomes anxious, upset, or overstimulated, what is the first thing we should try to help them feel calm and comfortable?
Your answer
Is there anything else we should know or helpful information about your child?
*
Your answer
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