Parents Night Out November 2, 2019
Sign your kids up for an evening of supper, games, crafts, cartoons, snacks, and a ton of fun.

Theme: 'Watch Us 'Glow'
Kids will get to play glow games and create a neon craft!
Cost: $10 + $5/additional sibling
Email address *
Parent Name *
Your answer
Parent Mobile *
Your answer
Child #1 Name *
Your answer
Child #1 Age/Grade *
Child #1 Allergies/Important information (if none, please state N/A) *
Your answer
Additional children. Must be in single household. $5/child.
Child #2 Name
Your answer
Child #2 Age/Grade
Child #2 Allergies/Important information (if none, please state N/A)
Your answer
Child #3 Name
Your answer
Child #3 Age/Grade
Child #3 Allergies/Important information (if none, please state N/A)
Your answer
Who will be picking up your child(ren) *
Name of Pick Up contact (if other than parent)
Your answer
Mobile Number of Pick Up contact (if other than parent)
Your answer
Additional information (if none, please write N/A) *
Your answer
Important Stuff to Know
-Students should wear comfortable shoes and clothes that can get paint on them.
- Please leave valuable objects at home. We will be playing games with glow sticks, glow in the dark balls in a dimly lit gym. We will have alternative activity for younger students if wanted.
-Supper will be pizza, fruit, veg, and lemonade.
- Students can bring pillows and blankets for movie section. 'Movie' will be a collection of appropriate cartoons.
Payment
$10/student + $5/additional sibling due at Drop Off.
No late/at the door registrations accepted.
Drop Off and Pick Up
Dropping off and pick ups will be at the front door of Stockton Grade School.

Parents/Pick ups must pick their children NO LATER than 9:15pm.
Waiver
As a guardian, I recognize and acknowledge that there are certain risks of physical injury and I agree the full risk of any injuries, including loss of life, damages or loss which I may sustain as a result of participation in any and all activities connected with or associated with such program. I further agree to waive and relinquish all claims, fully release and discharge and agree to indemnify and hold harmless and defend the Stockton Recreation, USD 271 and its officers, agents, servants, and employees from any and all claims resulting from injuries, including loss of life, damages, and losses sustained by me an arising out of connected with, or in any way associated with the activities of this program.

As a participant or guardian in this program, I give permission to Stockton Recreation Commission and USD 271 to take pictures and video for use on social media, and publication both print and online. SRC will never distribute or sell said images.
Electronic Signature (Name) *
Your answer
Date *
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Donations
If you would like to donate to this great event we would greatly appreciate it. Please see list below and drop off at Stockton Rec by Thursday Oct 31

-plates, cups, napkins
-bottled water
-cardboard boxes
-allergy free bulk snacks (no tree nuts) ex. plain m&m's, mike & ikes, animal crackers, pretzels
-monetary donations
A copy of your responses will be emailed to the address you provided.
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